重度慢性閉塞性肺疾患患者に対して全身麻酔中に投与したアミノフィリンにより心室性期外収縮が発生した一例

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Aminophylline, which is a potent and effective bronchodilator, is most useful for the treatment of bronchial spasms in pre- and intraoperative management. But it is well-known that the combination of aminophylline and inhalation often cause a severe ventricular arrhythmia. We reported that we suspected a premature ventricular constraction (PVC) was caused by administering intravenously aminophylline for controlled ventilation of a patient with severe chronic obstructive lung disease during general anesthesia. A 77-year-old male (height 155 cm, weight 54 kg) patient, diagnosed with right maxillary cyst, was scheduled for a right maxillary cyst extirpation under general anesthesia. Anesthesia was induced with thiopental sodium and maintained with N_2O, O_2 and sevoflurane. During the operation the patient was kept on controlled ventilation monitoring by per cutaneous SpO_2, arterial blood gas analysis, etc. without any complications. But it was suspected PVC occurred about five minutes after the intravenous administration of aminophylline given to prevent hypoxemia. It is important to take great care in administering medication, because drug-induced reactions, anesthetic stage and operative invasion may coincide to cause unexpected events.
2002-08-19