| Japanese |
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| Title | 硬膜外麻酔および脊椎麻酔中にみられた心電図異常 |
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| Subtitle | 原著 |
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| Authors | 田村高子*, 横山和子* |
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| Organization | *日本医科大学付属第1病院麻酔科 |
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| Journal | 循環制御 |
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| Volume | 10 |
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| Number | 3 |
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| Page | 433-438 |
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| Year/Month | 1989/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」硬膜外麻酔および脊椎麻酔中に心電図異常を呈した31症例について, その誘因, 治療の有無について検討した. 発生した不整脈の多くは洞性徐脈, 接合部調律, 房室解離等の徐脈性不整脈であった. 硬膜外および脊椎麻酔による交感神経緊張の変化, 特に心臓交感神経抑制は不整脈の主な誘因となる. 誘因となったものは, T4以上の高位交感神経ブロック：10例, 迷走神経反射2例, 治療目的で投与した薬剤(アトロピン, フェニレフリン, メトキサミン)によるもの：10例, 基礎疾患(高血圧, I度房室ブロック, 洞不全症候群)によるもの：7例, 大量出血による急激な血圧低下：2例, 患者の不安感1例, 痛み刺激：2例, 冠スパズム：1例であった. 治療は硬膜外麻酔では11例中6例に, 脊椎麻酔では20例中14例に必要とされた. 発生頻度は多くはないが, 誘因によっては重篤な不整脈が発生することもあり, 治療については注意深い対応が必要である. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Arrhythmia, Epidural anesthesia, Spinal anesthesia |
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| English |
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| Title | Arrhythmia during epiduaral and spinal anesthesia. Incidence and treatments |
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| Subtitle | |
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| Authors | Takako Tamura, Kazuko Yokoyama |
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| Authors(kana) | |
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| Organization | Dept. of Anesthesiology Daiichi Hospital Nippon Medical School |
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| Journal | Circulation Control |
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| Volume | 10 |
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| Number | 3 |
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| Page | 433-438 |
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| Year/Month | 1989/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Various kind of arrhythmia and its treatments during anesthesia epidural 11 cases or spinal 20 cases were investigated retrospectively. Those were sinus bradycardia (11 cases), junctional rhythm (11 cases), AV dissociation (5 cases) and others. The changes of sympathetic tone, especially cardiac sympathectomy due to the epidural or spinal anesthesia, produce various kind of arrhystmia. Other arrhythmogenic factors were hypotention, vagal reflex, anxiety, pain and preexsisting disease such as hypertention, sick sinus syndorome. Treatment such as vagolytic agent (atropine), vasopressor (phenirephrine, ephedorine), i.v fluid and oxygenation were applied for its necessity. However atropine as vagolytic agent should be used carefully because of its arrhythmogenic factor. The incidence of arrhythmia during epidural or spinal anesthesia is not high, but shoud be find out the reason why and some of them are needed prompt treatment. |
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| Practice | Basic medicine |
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| Keywords | Arrhythmia, Epidural anesthesia, Spinal anesthesia |
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