Bradycardia and hypotension refractory to ephedrine and atropine treatment: severe autonomic dysfunction with abnormal heart rate variability.
Diabetic patients with autonomic dysfunction are potentially poor risks for anesthesia and particular care is needed during and after surgery. We here report a 48-year-old male patient with diabetes mellitus who suffered from intraoperative hypotension and bradycardia which did not respond to ephedrine and atropine treatment and eventuated in cardiac arrest. A heart rate variability study confirmed the diagnosis of autonomic dysfunction after the event. Possible predisposing mechanisms and anesthetic considerations are discussed.
Horng
Huei-Chi
HC
Taichung Armed Forces General Hospital, Taiwan, ROC.
Chen
Fa-Chang
FC
Ho
Ching-Chih
CC
Kuo
Chang-Po
CP
Wu
Ching-Tang
CT
Wong
Chih-Shung
CS
D001285:Atropine / Q000627:therapeutic use*; D001342:Autonomic Nervous System Diseases / Q000150:complications*; D001919:Bradycardia / Q000188:drug therapy*; D048909:Diabetes Complications / Q000150:complications; D004809:Ephedrine / Q000627:therapeutic use*; D006323:Heart Arrest / Q000209:etiology; D006339:Heart Rate; D006801:Humans; D007022:Hypotension / Q000188:drug therapy*; D007431:Intraoperative Complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
D001285:Atropine; D004809:Ephedrine