糖胺酮后房室传导阻滞急性发作及快速消退1例:是否涉及自主神经系统?

IF 0.5

A&A Practice Pub Date : 2023-05-05 eCollection Date: 2023-05-01 DOI:10.1213/XAA.0000000000001683

Mohamed T Abdelrahim, Austin C Kassels, Cain W Stark, Christopher J Roberts, Julia A Vogt, Thomas J Ebert

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引用次数: 1

摘要

使用糖麦德来逆转神经肌肉阻滞可引起明显的心动过缓，很少有心脏停止。在这种情况下，快速发作，双相心率反应;在给药后，先减速后加速，在稳定状态下，1.3%尾潮七氟醚。在复查心电图(ECG)时，心率减慢与持续45秒的二度Mobitz I型阻滞同时发生。没有其他事件、药物或刺激与此事件同时发生。房室传导阻滞的急性发作和短暂性，没有缺血的迹象，表明给药后副交感神经对房室结有短暂的影响。

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A Case Report of Acute Onset and Rapid Resolution of Atrioventricular Block After Sugammadex: Is the Autonomic System Involved?

Administering sugammadex to reverse neuromuscular blockade can cause marked bradycardia and rarely asystole. In this case, a rapid onset, biphasic heart rate response; slowing then speeding, after administering sugammadex was noted while at steady state, 1.3% end-tidal sevoflurane. On review of the electrocardiogram (ECG), the heart rate slowing coincided with the onset of a second-degree, Mobitz type I block that lasted 45 seconds. No other events, drugs, or stimuli coincided with the event. The acute onset and transient nature of the atrioventricular block without evidence of ischemia implies a brief parasympathetic effect on the atrioventricular node after sugammadex administration.

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来源期刊

A&A Practice ANESTHESIOLOGY-

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期刊介绍： A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.