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KMID : 0352119930090020127
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Journal of Kyung Hee University
1993 Volume.9 No. 2 p.127 ~ p.134
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The Effects of Epinephrine on Cardiovascular System and Plasma Potassium Level in Pediatric Patients Undergoing Tonsillectomy Under Halothane Anesthesia
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Lee Young-Mi
Kim Keon-Sik
Kim Dong-Ok
Kang Hwa-Ja
Choi Young-Kyu
Shin Ok-Young
Lee Doo-Ik
Kim Dong-Soo
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Abstract
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Epinephrine is frequently injected, to achieve optimal local hemostasis in patients undergoing general anesthesia. When halothane is used concomitantly, the heart is sensitized by both endogenous and exogenous catecholamine and induce cardiac dysrhythmia and cardiovascular responses. The activation of beat-2 adrenoreceptors causes a dose-dependent decrease in plasma potassium, probably by shifting potassium in to the cell. By this mechanism, epinephrine may cause hypokalemia and leads to cardiac arrhythmia. Forty patients undergoing elective tonsillictomy were selected and divided into two groups, saline injected group and epinephrine injected group. Authors observed the effects of epinephrine on cardiovascular system and serum potassium level of the two groups under halothane anesthesia.
Results are as followed. 1) Systoic blood pressure increased significantly one minute after injection of saline in control group (p<0.05) and one, five and ten minutes after injection of epiniphrine experimental group (p<0.05) as compared to the level on admission. Comparing the two groups, the expeimental group showed significant increase in five and ten minute after injection (p<0.05). 2) Heart rate increased in both group as compared to the level on admission (p<0.05) and increase in experimental group was more significant than in control group one minute after injection (p<0.05) 3) Seum potassium level of the control group decreased significantly just before induction and injection, and one minute after injection, then recovered slowly (p<0.05). Comparing the two groups, the experimental group showed decreases after five and ten menutes following injection but not statistcally significant. 4) The changes in serum sodium level in both groups showed no significant difference. the same is two when compared to the level on admission. 5) Monitoring EKG, ventricualr premature beasts were shown in one case out of 20 of experimental group. Epinephrine injected for bleeding control during tonsillectomy under halothane anesthesia may cause dysrhythmia by synsitizing cardiac muscles. It is thought that hypokalemia may exerts adverse effects on cardiovascular system but no such problem occured when<3 g/kg of epinephrine was administered as in this study.
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