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KMID : 0356920080540010084
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Korean Journal of Anesthesiology
2008 Volume.54 No. 1 p.84 ~ p.87
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Acute Myocardial Infarction during General Anesthesia Combined with Epidural Anesthesia
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Chung Jin-Hun
Seo Yong-Han
Ahn Ki-Ryang
Kim Chun-Sook
Kang Kyu-Sik
Yoo Sie-Hyeon
Chung Ji-Won
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Abstract
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The general anesthesia combined with epidural anesthesia have many advantages, which are including early recovery, postoperative analgesia, and less requirement of inhalation anesthetic. But the complications of epidural anesthesia such as total spinal anesthesia, respiratory depression, myocardial ischemia, and local anesthetic toxicity can lead to cardiac arrest. We report a case of acute myocardial infarction in a 74-year-old female patient receiving general anesthesia combined with epidural anesthesia. The profound hypotension without bradycardia and ST-segment elevation in lead II occurred 1 hour after local anesthetic injection and cardiac arrest followed. After the injection of atropine, epinephrine and dopamine, and external cardiac massage, sinus rhythm was restored. Postoperative serial examinations of ECG showed ST-segment elevation in leads II, III, aVF and serum enzymes such as CPK, CK-MB, and Troponin T were elevated. Emergency percutaneous transluminal coronary angioplasty was performed and the patient recovered uneventfully. (Korean J Anesthesiol 2008; 54: 84∼7)
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KEYWORD
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acute myocardial infarction, cardiac arrest, epidural anesthesia
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