[A case of cardiac arrest after torsades de pointes due to prolonged QT interval syndrome possibly associated with subarachnoid hemorrhage].
An 58-year-old woman with prolonged QT interval syndrome possibly associated with subarachnoid hemorrhage underwent clipping for cerebral artery aneurysm. Anesthesia was induced with diazepam, fentanyl and vecuronium, and maintained with nitrous oxide (66%)-oxygen and sevoflurane (1%) with fentanyl. However, three hours after the start of operation, torsades de pointes suddenly appeared and cardiac arrest was followed. After cardiopulmonary resuscitation, sinus rhythm was restored. At that time, serum potassium was decreased to 2.7 mEq.l-1. Five days after the operation, she died despite cardiopulmonary resuscitation for frequent episodes of ventricular tachycardia including torsades de pointes. Ventricular tachycardia including torsades de pointes may have been caused by decreased serum potassium.
First Department of Anesthesiology, Dokkyo University School of Medicine, Tochigi.
S
S
Yamaguchi
K
K
Watanabe
M
M
Mishio
Y
Y
Okuda
T
T
Kitajima
D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery; D004232:Diuretics / Q000009:adverse effects; D017809:Fatal Outcome; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery; D007431:Intraoperative Complications / Q000209:etiology; D008133:Long QT Syndrome / Q000209:etiology*; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000601:surgery; D016171:Torsades de Pointes / Q000209:etiology*
D018686:Anesthetics, Intravenous; D004232:Diuretics; D005283:Fentanyl