621-5340, Fax: 82-32-621-5322, E-mail: [email protected] CC That is an open-access report distributed below the terms on the Inventive Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, supplied the original operate is correctly cited.Copyright the Korean Society of Anesthesiologists,www.ekja.orgAV block following propofol administrationVol. 64, No. four, April 2013 applied. Her vital indicators have been pulse price, 76 beats/min (bpm); oxygen saturation, 97 ; and blood stress, 177/83 mmHg. Anesthesia was induced with 40 mg lidocaine and 60 mg propofol. Rocuronium was offered at a dose of 0.6 mg/kg to facilitate endotracheal intubation right after loss of consciousness. Soon after a handful of minutes, the ECG showed a total AV block and ventricular rhythm of about 40 bpm (Fig. two). Despite the administration of 0.five mg atropine, the arrhythmia persisted (blood pressure, 90/40 mmHg; pulse price, 30-49 bpm). At that time, her trachea was intubated using a 7.0-sized endotracheal tube beneath direct laryngoscopy, and a radial arterial line was placed for continuous arterial stress monitoring and blood gas analysis. A central venous catheter was also inserted by way of the proper internal jugular vein catheter. About ten minutes soon after the propofol injection, her blood pressure was 145/55 mmHg, and her pulse rate was 66 bpm. The ECG showed a sinus rhythm. The operation was delayed, and she was transferred for the intensive care unit till completely awake for close observation and additional evaluation. We assessed the patient’s creatine kinase-MB, troponin T,Case ReportAn 80-year-old woman (weight, 53 kg; height, 154 cm) was scheduled for TKRA from the left knee as a consequence of degenerative joint illness.Oxibendazole She was diagnosed with hypertension 1 year ago but did not get any medication.Propidium Iodide Preoperative blood and coagulation tests had been normal. She had not undergone any previous operations. At admission, her very important indicators had been steady. Preoperative electrocardiography (ECG) showed normal sinus rhythm and a complete ideal bundle branch block (Fig.PMID:23756629 1). A chest X-ray showed a hypertensive heart contour. We did not execute an echocardiogram, because it was obtained at another hospital, and cardiac function was standard except for the hypertension. The patient was premedicated with glycopyrrolate 0.2 mg intramuscularly 30 min prior to anesthesia. Upon arrival within the operating area, standard ECG, pulse oximeter, noninvasive blood stress, and bispectral index monitoring (Model A-2000; Aspect Health-related Systems, Newton, MA, USA) wereFig. 1. Preoperative electrocardiogram.Fig. 2. Total atrioventricular block that occurred when propofol was injected.www.ekja.orgKorean J AnesthesiolNoh, et al.Fig. three. Electrocardiogram taken soon after insertion of a permanent pacemaker.and myoglobin, and all values had been regular. An echocardiography taken the subsequent day exhibited a left ventricular ejection fraction of 63 , which was suggestive of an indeterminate left ventricular filling pattern due to complete AV block. Also, a 24-h ECG Holter monitor showed AV dissociation. Three-dimensional (3D) computed tomography of the heart revealed that the proximal and middle parts with the left anterior descending artery had been narrowed by 50 . She also had a focal aortic valve and mitral annular calcification. We had planned to carry out the surgery once again. She received a short-term pace maker (VDD mode) using the minimum r.