Coronary Spasm During Postoperative Sedation With Dexmedetomidine.
Anesth Prog
; 69(3): 20-24, 2022 09 01.
Article
em En
| MEDLINE
| ID: mdl-36223192
ABSTRACT
This is a case report of an 81-year-old woman who underwent tracheostomy, bilateral cervical dissection, partial tongue resection, radial forearm free flap reconstruction, and split-thickness skin grafting under general anesthesia. After successful surgery, she was moderately sedated postoperatively with intravenous dexmedetomidine (DEX) and fentanyl. The fentanyl was discontinued 5 hours postoperatively. Eight hours after the operation, an atrioventricular junctional rhythm, a 2-mm elevation of the ST segment, and biphasic T waves were detected in lead II that lasted approximately 3 minutes. Hypotension and bradycardia were observed simultaneously with the abnormal electrocardiogram. The next day, a cardiologist examined the patient and suggested that coronary spasm had occurred based on those findings. The transient coronary spasm was likely caused by a combination of various factors including surgical stress and altered autonomic function. However, it is possible that stimulation of α-2 adrenergic receptors induced by DEX may also be linked to the coronary vasospasm that occurred.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vasoespasmo Coronário
/
Dexmedetomidina
Tipo de estudo:
Diagnostic_studies
Limite:
Aged80
/
Female
/
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article