Tonsillectomy 22 years ago under general anaesthesia withoutĬomplications, caesarean section 6 years ago for circular cord with spinal The patient reported that she was fasting for more than two hours and the pre-anaesthetic evaluation is detailed below: The Obstetrics and Gynaecology Department decided to terminate the pregnancy with the diagnosis of pregnancy at 39.2 weeks, previous caesarean section and prodromal labour, and requested an assessment by anaesthesiology. Patient is 39, 2 weeks pregnant weeks gestation due to the last menstrual period (FUM), previous Caesarean section, obstetric formula: G2C1P0A0. Paciente A 33 year old female patient from Cercado - Cochabamba, on 03 June 2019 goes to the Gynecology-Obstetrics emergency department of the Hospital Obrero N° 2 “Caja Nacional de Salud”. Most of the adverse effects associated with the use of dexmedetomidine occur during or immediately after the attack dose 8. Overdose can cause first- or second-degree atrioventricular block. Īdverse effects of dexmedetomidine include initial hypertension, hypotension, nausea, bradycardia, atrial fibrillation, pulmonary oedema, oliguria and thirst 7. The effects of drugs to the foetus are avoided, anaesthesiologists generally do not use sedatives and other drugs before birth 3.Īrrhythmia and tachycardia are very common in pregnant women, although spinal block may be a safe anaesthetic technique, severe tachycardia, cardiac arrest and other arrhythmias are reported during spinal anaesthesia practices 4.īupivacaine and levobupivacaine may increase the PR interval and QRS duration thereby prolonging cardiac conduction 5.ĭexmedetomidine is a potent and highly selective high-selective α-2-adrenoceptor agonist with sympatholytic, sedative, respiratory stability without ventilatory depression, amnesic and analgesic properties, which has already been described as a useful and safe supplement in several clinical applications 6. Neuroaxial anaesthesia is considered the preferred method of obstetric analgesia and anaesthesia for vaginal or caesarean delivery care. Los agentes anestésicos pueden presentar actividad pro-arritmica y antiarritmica al inducir actividad eléctrica por medio de varios mecanismos 2.Īnaesthetic agents can exhibit both proarrhythmic and anti-arrhythmic activity by inducing electrical activity through various mechanisms 2. Palabras clave: arritmia sinusal, dexmedetomidina, anestesia espinal.Ĭardiac arrhythmias are a major cause of morbidity and mortality during the perioperative period, as well as in critically ill patients in intensive care units (ICU) 1. En conclusión la presencia de arritmias cardiacas puede deberse a varios factores, es trascendental la vigilancia y monitoreo continuo del electrocardiograma para reconocer y corregir de manera oportuna. Recibe anestesia espinal y a los 10 min bradicardica de 39 corregida con atropina y posterior con arritmia sinusal. Paciente de 33 años de edad con embarazo de 39,2 sem. La dexmedetomidina tiene propiedades simpaticolíticas, sedativas, estabilidad respiratoria sin depresión ventilatoria, amnésicas y analgésicas, los efectos adversos de la dexmedetomidina son la hipertensión inicial, hipotensión, naúseas, bradicardia, fibrilación atrial, edema pulmonar, oliguria y sed. La bupivacaina y levobupivacaina pueden aumentar el intervalo PR y la duración del QRS y prolongar la conducción cardiaca. La arritmia y taquicardia son muy comunes en las embarazadas, aunque el bloqueo espinal pueda ser una técnica anestésica segura, la taquicardia grave, la parada cardiaca y otras arritmias son relatadas durante las prácticas de raquianestesia. Keywords: sinus arrhythmia, dexmedetomidine, spinal anesthesia. In conclusion, the presence of cardiac arrhythmias may be due to several factors, and continuous monitoring of the electrocardiogram is essential to recognise and correct them in a timely manner. She received spinal anaesthesia and after a 10 min bradycardia of 39 corrected with atropine and later with sinus arrhythmia. The patient is 33 years old and 39.2 weeks pregnant, with no history of pathology. Dexmedetomidine has sympatholytic, sedative, respiratory stability without ventilatory depression, amnesic and analgesic properties, adverse effects of dexmedetomidine are initial hypertension, hypotension, nausea, bradycardia, atrial fibrillation, pulmonary edema, oliguria and thirst. Bupivacaine and levobupivacaine may increase the PR interval and QRS duration and prolong cardiac conduction. This work is licensed under Creative Commons Attribution-ShareAlike 4.0 International.Īrrhythmia and tachycardia are very common in pregnant women, although spinal block may be a safe anaesthetic technique, severe tachycardia, cardiac arrest and other arrhythmias are reported during spinal anaesthesia practices.
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