背景:尽管腹腔镜外科手术具有多种优势,人工气腹可能导致血流动力学波动,包括严重的心动过缓和心脏骤停。阿托品通常用于治疗术中严重的心动过缓(<40次/分钟)。然而,阿托品可诱发室性心律失常,在严重的情况下可能会危及生命。
方法:这里,我们报道了一名41岁女性,被诊断为胆囊息肉,并计划在全身麻醉下进行腹腔镜胆囊切除术.
方法:术中突然出现心动过缓,静脉注射阿托品。最终患者出现室性心动过速和急性心力衰竭。
方法:我们组织了一次紧急会诊,患者立即接受治疗。
结果:幸运的是,经及时诊断和治疗,患者无并发症发生。经过6个月的随访,她的纽约心脏协会分类是我没有并发症.
结论:该案例强调了阿托品治疗心动过缓可能导致室性心动过速和急性心力衰竭,麻醉医师应保持警惕,避免可能危及生命的后果.
BACKGROUND: Despite various advantages of laparoscopic surgical procedures, artificial pneumoperitoneum might lead to hemodynamic fluctuations including severe bradycardia and cardiac arrest.
Atropine is usually proposed to treat intraoperative severe bradycardia ( < 40 beats per minute). However,
atropine could induce ventricular arrhythmias, which might be life-threatening in severe
case.
METHODS: Here, we reported a 41-year-old female who was diagnosed with gallbladder polyps and was scheduled for laparoscopic cholecystectomy under general anesthesia.
METHODS: Bradycardia occurred suddenly during the operation and
atropine was injected intravenously. Eventually the patient developed ventricular tachycardia and acute heart failure.
METHODS: We organized an urgent consultation and the patient was treated immediately.
RESULTS: Fortunately, the patient experienced no complications after timely diagnosis and treatment. After 6 months of follow-up, her New York Heart Association classification was I with no complications.
CONCLUSIONS: This
case highlighted that the administration of
atropine to treat bradycardia may lead to ventricular tachycardia and acute heart failure, and anesthesiologists should remain vigilant to avoid potentially life-threatening consequences.