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首页> 外文期刊>麻酔 >Successful control of rapid heart rate with atrial flutter by intravenous administration of esmolol in a patient after total correction of the tetralogy of Fallot
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Successful control of rapid heart rate with atrial flutter by intravenous administration of esmolol in a patient after total correction of the tetralogy of Fallot

机译:完全校正了法洛四联症后,通过静脉注射艾司洛尔成功地控制了房扑的快速心率

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摘要

A 30-year-old woman with atrial flutter after surgical correction of tetralogy of Fallot, underwent gynecological procedure under general anesthesia. Because she had been noted to have atrial flutter and heart failure at 8 weeks' gestation, she was scheduled for dilatation and curettage. Chest X-ray film showed cardiomegaly and pulmonary congestive changes. ECG showed atrial flutter with 3:2 atrio-ventricular conduction rate and complete right branch block. She was anesthetized with propofol infused with target-controlled infusion system, fentanyl and 66% of nitrous oxide under close monitoring and appropriate respiratory management. The quantity of hemorrhage was about 850 ml, and hypovolemia was treated with volume infusion and the use of vasoactive drugs. Soon after emergence from anesthesia, atrial flutter with 1:1 A-V conduction (> 230 bpm) occurred suddenly. Esmolol hydrochloride, 30 mg, was administered. Despite the relatively low doses, rapid control of heart rate was possible in a few minutes and the atrial flutter returned to 2:1 conduction. Although atrial flutter had continued until the discharge, tachyarrhythmia was no longer observed and the heart resumed sinus rhythm 3 month after the operation. The present case suggests that esmolol can be used effectively and safely for controling atrial flutter with rapid ventricular response in a patient after surgical correction of tetralogy of Fallot.
机译:一名30岁女性,在对Fallot四联症进行手术矫正后出现房扑,并在全身麻醉下进行了妇科手术。由于已经注意到她在妊娠8周时出现房扑和心力衰竭,因此安排进行扩张和刮除术。胸部X光片显示心脏肥大和肺充血改变。心电图显示房扑具有3:2的房室传导率和完整的右分支传导阻滞。在密切监测和适当的呼吸控制下,将丙泊酚与靶控输注系统,芬太尼和66%的一氧化二氮一起注入麻醉药中。出血量约为850毫升,并通过大量输注和使用血管活性药物治疗血容量不足。麻醉后不久,突然发生了1:1 A-V传导(> 230 bpm)的房扑。施用艾司洛尔盐酸盐30mg。尽管剂量相对较低,但几分钟内仍可快速控制心率,并且房扑恢复为2:1传导。尽管房扑一直持续到出院,但术后3个月仍未观察到快速性心律失常,心脏恢复了窦性心律。目前的情况表明,在对法洛氏四联症进行手术矫正后,艾司洛尔可有效安全地用于控制具有快速心室反应的房扑。

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