Second-degree atrioventricular block induced by electrical stimulation of transcranial motor-evoked potential: a case report.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2024-06-12 DOI:10.1186/s40981-024-00722-3

Toru Murakami, Satoshi Tanaka, Ryusuke Tanaka, Mariko Ito, Takashi Ishida, Mikito Kawamata

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引用次数: 0

Abstract

Background: Although several complications of transcranial motor-evoked potentials (Tc-MEPs) have been reported, reports of arrhythmias during Tc-MEP are very rare.

Case presentation: A 71-year-old woman underwent transforaminal lumbar interbody fusion under general anesthesia, with intraoperative Tc-MEP monitoring. Preoperative electrocardiography showed an incomplete right bundle branch block but no cardiovascular events in her life. After induction of anesthesia, Tc-MEP was recorded prior to the surgery. During the Tc-MEP monitoring, electrocardiography and arterial blood pressure showed a second-degree atrioventricular block, but it improved rapidly at the end of the stimulation, and the patient was hemodynamically stable. Tc-MEP was recorded seven times during surgery; the incidence of P waves without QRS complexes was significantly higher than before stimulation. The surgery was uneventful, and she was discharged eight days postoperatively without complications.

Conclusions: Our case suggests that electrical stimulation for Tc-MEP can cause arrhythmia. Electrocardiography and blood pressure must be closely monitored during Tc-MEP monitoring.

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经颅运动诱发电位电刺激诱发二度房室传导阻滞：病例报告。

背景：虽然经颅运动诱发电位（Tc-MEPs）的并发症已有报道，但 Tc-MEP 期间出现心律失常的报道却非常罕见：一名 71 岁的女性在全身麻醉下接受了经椎间孔腰椎椎间融合术，术中进行了 Tc-MEP 监测。术前心电图显示她有不完全右束支传导阻滞，但生前未发生过心血管事件。麻醉诱导后，手术前记录了锝-MEP。锝-MEP监测期间，心电图和动脉血压显示二度房室传导阻滞，但在刺激结束后迅速好转，患者血流动力学稳定。手术过程中记录了七次锝-MEP；无 QRS 波群的 P 波发生率明显高于刺激前。手术顺利，术后八天出院，无并发症：我们的病例表明，锝-MEP 电刺激可导致心律失常。结论：我们的病例表明，Tc-MEP 电刺激可能导致心律失常，在 Tc-MEP 监测期间必须密切监测心电图和血压。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.