title: Anaesthetic induction in a child with end-stage cardiomyopathy.
abstract: The purpose of this clinical report is to discuss the anaesthetic management of a patient with end-stage cardiomyopathy. An eight-year-old boy sustained electro-mechanical dissociation following a "standard anaesthetic induction" but was subsequently successfully anaesthetized using a combination of etomidate, midazolam, lidocaine, vecuronium and glycopyrrolate. Anaesthetic techniques and their relationship to the specific category of cardiomyopathy (dilated, hypertrophic or restrictive) are discussed. The potential detrimental effects of anaesthetic sympatholysis, myocardial depression and negative chronotropy on cardiac output are explained.
authors.affiliation: Department of Anesthesia, Children's Hospital, Boston, MA 02115, USA.
authors.forename: W S
authors.initials: WS
authors.lastname: Schechter
authors.forename: C
authors.initials: C
authors.lastname: Kim
authors.forename: M
authors.initials: M
authors.lastname: Martinez
authors.forename: B F
authors.initials: BF
authors.lastname: Gleason
authors.forename: D P
authors.initials: DP
authors.lastname: Lund
authors.forename: F A
authors.initials: FA
authors.lastname: Burrows
mesh_terms: D000771:Anesthesia, Intravenous / Q000009:adverse effects; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology*; D002648:Child; D004750:Enteral Nutrition / Q000295:instrumentation; D005045:Etomidate / Q000008:administration & dosage; D005773:Gastroscopy; D005774:Gastrostomy / Q000295:instrumentation; D006024:Glycopyrrolate / Q000008:administration & dosage; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D017180:Tachycardia, Ventricular / Q000503:physiopathology; D014673:Vecuronium Bromide / Q000008:administration & dosage
chemical_list: D014673:Vecuronium Bromide; D008012:Lidocaine; D008874:Midazolam; D006024:Glycopyrrolate; D005045:Etomidate