| Japanese |
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| Title | セボフルレン麻酔下に房室解離をきたした一症例 |
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| Subtitle | 症例 |
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| Authors | 横山和子*, 瓦井俊孝**, 吉川秀康** |
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| Authors(kana) | |
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| Organization | *日本医科大学第一病院麻酔科, **虎の門病院麻酔科 |
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| Journal | 循環制御 |
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| Volume | 14 |
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| Number | 2 |
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| Page | 203-205 |
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| Year/Month | 1993/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 麻酔中は自律神経のバランスが崩れることにより, または循環動態の変化に伴い, さまざまな不整脈が出現する. 今回われわれは術前心電図で全く異常を認めず, セボフルレン麻酔中に特別な循環動態の変動も認めることなく, 突然房室解離となった症例を経験したので報告する. 「症例」52歳の男性, 身長166cm, 体重63kg. 既往歴と家族歴に特記すべきことはなかった. 現病歴は1991年7月嗄声に気付き, 耳鼻科受診, 声帯ポリープを指摘され, 1992年11月入院, 手術となった. 術前検査で問題点はなく, 血圧は128/64mmHg, 心拍数72/min, 心電図は図1に示すごとく, 循環系に異常所見を認めなかった. 麻酔経過：前投薬はアトロピン0.5mg, ヒドロキシジン50mgを入室30分前に筋注した. 手術室入室後, 心電計, 血圧計, パルスオキシメトリーを装着, 静脈路を確保した. 血圧は132/80mmHg, 心拍数80/minであった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | A-V dissociation, Sevoflurane, Atrial kick |
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| English |
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| Title | A-V Dissociation under Sevoflurane Anesthesia - a Case Report. |
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| Subtitle | |
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| Authors | Kazuko Yokoyama*, Toshitaka Kawarai**, Hideyasu Yoshikawa** |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology,Daiichi Hospital Nippon Medical School, **Department of Anesthesiology,Toranomon Hospital |
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| Journal | Circulation Control |
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| Volume | 14 |
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| Number | 2 |
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| Page | 203-205 |
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| Year/Month | 1993/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A case of A-V dissociation under sevoflurane anesthesia was reported. Fifty-two years old male patient, had a polyp on his vocal cord and scheduled for laryngo-micro-surgery. He had no complication and no abnormal laboratory finding before the surgery. He had premedicated with atropine 0.5 mg and hydroxyzine 50 mg intramusculary one hour before the surgery. In the operating room, he had a blood pressure of 132/80 mmHg and heart rate of 80/min. Anesthesia was induced with thiopental 4 mg/kg and maintained with 2.0% of sevoflurane/nitrous oxide and oxygen. The end of ten minutes surgery, heart rate was suddenly dropped from 80 to 60/minutes. ECG monitor showed A-V dissociation. However no blood pressure drop was noticed with this A-V dissociation. After 10 minutes withdrawal inhalation anesthetics, heart rate gradually. increased to 84/min. and returned to normal sinus rhythm. No special treatment was required what so ever, however atropine is the treatment of choice. This A-V dissociation probably due to the imbalance of autonomic nervous system under deep sevoflurane anesthesia and this sometime is associated with severe hypotension due to the loss of atrial kick. |
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| Practice | Basic medicine |
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| Keywords | A-V dissociation, Sevoflurane, Atrial kick |
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