title: "Crime scene investigation" at an anesthetic cocktail party with atrioventricular dissociation.
abstract: A healthy 21-year-old female patient received midazolam, propofol, fentanyl, rocuronium, nitrous oxide in oxygen, ranitidine, diclofenac, neostigmine and glycopyrrolate during the anesthetic process for elective knee arthroscopy and developed a complete AV dissociation with a P-wave frequency of 40 and a "small" QRS-complex frequency of 55 beats/min. Based on this typical case of poly-pragmatic anesthetic drug administration causing a complete atrioventricular dissociation in a young healthy patient we will discuss the possible pharmacodynamic mechanisms of all used drugs with regard to the cardiac conduction system.
authors.affiliation: Dept. of Anesthesiology and Critical Care Medicine, Trauma Hospital Klagenfurt, Austria. c.schlimp@gmx.at
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Schlimp
authors.forename: Franz J
authors.initials: FJ
authors.lastname: Wiedermann
mesh_terms: D000759:Adjuvants, Anesthesia / Q000009:adverse effects; D000777:Anesthetics / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D001182:Arthroscopy; D054537:Atrioventricular Block / Q000139:chemically induced*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006024:Glycopyrrolate / Q000009:adverse effects; D006635:Histamine H2 Antagonists / Q000009:adverse effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007717:Knee / Q000601:surgery; D009388:Neostigmine / Q000009:adverse effects; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects; D019338:Polypharmacy; D011899:Ranitidine / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000759:Adjuvants, Anesthesia; D000777:Anesthetics; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D002800:Cholinesterase Inhibitors; D006635:Histamine H2 Antagonists; D006993:Hypnotics and Sedatives; D003473:Neuromuscular Nondepolarizing Agents; D009388:Neostigmine; D011899:Ranitidine; D006024:Glycopyrrolate