论文部分内容阅读
作者报告一例每次静注利多卡因后都并发窦性心动过缓。患者,男性,71公斤。心肌梗塞后4星期,计划置入Austin Moore假肢治疗髋部骨折。患者曾有用过狄戈辛和速尿治疗左心衰竭和用普鲁卡因酰胺控制室性异位心律的历史,术前24小时的动态心电图监护和12导联心电图显示无明显的窦房结疾病。血清狄戈辛浓度是0.6ng/dl,血清钾浓度是4.1mEq/L。手术日晨停用普鲁卡因酰胺。麻醉诱导用安定、氟烷和利多卡因100mg15秒左右快速静注完毕,30秒后,心率突然从92次/分降到60次/分,正常的窦性节律,血压从160/90mmHg降到80/50mmHg,静注琥珀胆碱80mg、快速气管内插管后,血压和心率仅各自逐渐上升到140/80mmHg和90次
The authors report a case of sinus bradycardia after intravenous injection of lidocaine. Patient, male, 71 kg. Four weeks after myocardial infarction, Austin Moore prosthesis is planned for the treatment of hip fractures. Patients had history of treatment of left heart failure with Digoxigen and furosemide and control of ventricular ectopy with procainamide. Preoperative 24-hour ambulatory electrocardiogram monitoring and 12-lead electrocardiography showed no significant sinus node disease. Serum Digoxin concentration 0.6ng / dl, serum potassium concentration is 4.1mEq / L. Deactivation of procainamide on the morning of surgery. Anesthesia induction with diazepam, halothane and lidocaine 100mg15 seconds rapid intravenous injection is completed, 30 seconds later, the heart rate suddenly dropped from 92 beats / min to 60 beats / min, normal sinus rhythm, blood pressure dropped from 160 / 90mmHg 80 / 50mmHg, intravenous injection of succinylcholine 80mg, rapid tracheal intubation, blood pressure and heart rate only gradually increased to 140 / 80mmHg and 90 times