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Sevoflurane-induced Bradycardia in An Adult Patient Undergoing Noncardiac Surgery

경희의학 2019년 34권 1호 p.65 ~ 70
안상은, 강희용,
소속 상세정보
안상은 ( Ahn Sang-Eun ) - Kyung Hee University Hospital Department of Anesthesiology and Pain Medicine
강희용 ( Kang Hee-Yong ) - Kyung Hee University Hospital Department of Anesthesiology and Pain Medicine

Abstract


Sevoflurane is a commonly used inhalation anesthetic agent. Although it is known to have little effect on cardiac conduction pathways, occasional tachycardia has been reported during anesthesia using sevoflurane, but bradycardia has rarely been reported except in patients with Down syndrome. A 70-year-old man with a history of mitral valve replacement was admitted for surgery of hallux valgus. When the exhaled concentration of sevoflurane reached 1.5% for maintenance of anesthesia just after tracheal intubation, atrial fibrillation with bradycardia and hypotension were observed. Atropine was administered for the treatment, but was not effective. Bradycardia and hypotension disappeared at the exhaled sevoflurane concentration of 0.5%. In the provocation test, the same vital signs were observed according to the change in the concentration of sevoflurane. The surgery was decided to postpone, and the patient was admitted to the intensive care unit for further evaluation. The patient was discharged from the hospital without complication. Herein, we reported a case of severe bradycardia caused by low concentrations of sevoflurane in an adult patient undergoing noncardiac surgery.

키워드

Autonomic nervous system; Bradycardia; Sevoflurane

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