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Cardiovascular Collapse after General Anesthetic Induction Combined With Esmolol

在全身麻醉誘導時併用Esmolol發生心血管塌陷之病例報告

摘要


esmolol常用於麻醉的誘導中,以減少置放氣管內管時所引起的心臟血管反應。由於esmolol的半衰期相當短,它被認爲是一個相對安全的藥物。在此我們報告一個四十九歲患有糖尿病並將接受玻璃體切除手術的女性病人,她在合併使用esmolol的全身麻醉誘導之後,突然發生嚴重的休克與心跳停止。即使一再給予包括腎上腺素在內的升壓藥物,仍無法避免休克的發生。此病患在經過大約4四十分鐘的急救之後,才恢復生命徵象。事後的各種檢查並無發現心肌梗塞或過敏性休克等病因。在此報告中,我們探討了休克可能的發生原因,並回顧esmolol的相關毒性反應及其處理方法。

並列摘要


Esmolol chloride was commonly used in anesthetic induction to blunt cardiovascular responses of tracheal intubation. Because of its short half-life, esmolol was considered as a relative safe agent in anesthetic practice. Here, we present a 49-year-old diabetic female patient scheduled for vitrectomy. She suffered from a cardiovascular collapse after general anesthetic induction combined with esmolol. The bradycardia and shock cannot be corrected with repeated doses of adrenergic agents including epinephrine. Cardiopulmonary resuscitation persisted for forty minutes to regain the vital sign. The followed examinations didn't reveal definite pathology such as acute myocardial infarction or anaphylaxis. In this report, we discussed the possible causes of shock and reviewed the esmolol-related cardiovascular collapse and its treatment.

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