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KMID : 0352120190340010065
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Journal of Kyung Hee University
2019 Volume.34 No. 1 p.65 ~ p.70
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Sevoflurane-induced Bradycardia in An Adult Patient Undergoing Noncardiac Surgery
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Ahn Sang-Eun
Kang Hee-Yong
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Abstract
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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.
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KEYWORD
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Autonomic nervous system, Bradycardia, Sevoflurane
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