J.Jpn. Surg. Soc.. 81(9): 1004-1009, 1980

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Report on the annual meeting

GENERAL SURGERY AND ARRHYTHMIAS

During the surgery various types of arrhythmias are observed and some of them are considered as dangerous threat to the patient's life. Anesthetic agents were surveyed on their property of inducing arrhythmia. Halothane has a negative chronotropic action on the SA nodal fibers, and this is the result of reduced rate of slow diastolic depolarization and an increase in threshold potential. The decrease in rate is not prevented by atropine. Induced arrhythmia by combined use of halogenated hydrocarbon and catecholamine is clinically very important and should be carefully avoided. Succinylcholine chloride causes serious trouble occasionally on its initial and repeated use. Vagal suppression, acetylcholine like action, and release of K^＋ may play important role.
Ventricular extrasystoles are most common. Multifocal PVC, “R on T” type and “Short run” are most dangerous types which need immediate treatment. Anesthetic management of Q-T prolongation syndrome, W-P-W syndrome and digitalis intoxication offer serious problems during anesthesia. Ventricular tachycardia should be treated immediately, and its recovery is good in operating theater and in ICU and CCU. Preoperative insertion of pacemaker should be carefully evaluated. Trifascicular block, CRBBB+ MLAD+ 2° AV block, history of Adams-Stokes syndrome or transient complete block, and prolongation of H-V time (over 65 msec) are author's criteria. Lidocaine, Beta-blockers, procainamide, disopyramide and bretylium are commonly used for the treatment of arrhythmia during anesthesia.

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