局所麻酔直後に一過性に心室頻拍様心電図(Wide QRS Tachycardia)を呈した小児の1例

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We experienced a case where transient wide QRS tachycardia like a ventricular tachycardia was recognized on the Electrocardiogram immediately after local anesthesia was administered to an infant. The patient was a 2-year-old boy with severe dental phobia who had been scheduled for dental treatment under general anesthesia. Oxygen-nitrous oxide-sevoflurane was administered for the induction and the maintenance of general anesthesia. General anesthesia and cardiovascular condition were sufficiently stable from the induction to the maintenance. Immediate after 1.8ml of local anesthetic (2% lidocaine with 1:80,000 epinephrine) was injected into gingival mucosa for the dental treatment, transient wide QRS tachycardia like a ventricular tachycardia was recognized on the electrocardiogram. Fortunately, the arrhythmia recovered to the regular sinus rhythm within about one minute without any therapy. Thereafter, the anesthesia and operation progressed smoothly. The next morning, he was discharged from the hospital without any problem. In recent years, general anesthesia has become safe, and arrhythmia due to general anesthesia has decreased remarkably. On the contrary, reports of accidental death involving local anesthesia has been increasing. Especially, many infants are dying of shock due to local anesthesia under restraint dental treatment. If we applied the. local anesthesia under restraint dental treatment for this case, arrhythmia might have deteriorated furthermore and arrhythmia treatment might have been delayed. We have to pay sufficient attention to the patient's general condition during local anesthesia.
奥羽大学の論文
2005-12-30

局所麻酔直後に一過性に心室頻拍様心電図(Wide QRS Tachycardia)を呈した小児の1例

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