[Anesthetic management for pacemaker implantation of a child with hypertrophic cardiomyopathy and sick sinus syndrome].
A 5-year-old boy weighing 15 kg with hypertrophic cardiomyopathy and sick sinus syndrome was scheduled to undergo implantation of permanent pacemaker without a temporary intravenous pacemaker, because he frequently complained of chest pain and fell into syncope due to hypotension associated with tachycardia when he was agitated. Thus, the most important point in the anesthetic management of this patient was to avoid tachycardia prior to and during general anesthesia. After the patient was premedicated with oral pentobarbital 50 mg and intramuscular morphine 3 mg, he seemed to be calm in the operating room. General anesthesia could be smoothly induced and maintained with halothane, nitrous oxide and fentanyl. During anesthesia, inspired concentration of halothane was chosen on the basis of Q-F time (the time between Q wave on the electrocardiogram and the initial upstroke of arterial pressure wave). The anesthetic course was uneventful. In this case an appropriate preanesthetic medication appeared to be essential, and the measurement of Q-F time was useful for the anesthetic management.
Taguchi
N
N
Department of Anesthesiology, Tsukuba University Hospital.
Ishizawa
Y
Y
Nishikawa
T
T
Naito
H
H
D000768:Anesthesia, General / Q000379:methods*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000628:therapy*; D002675:Child, Preschool; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012804:Sick Sinus Syndrome / Q000628:therapy*