Life-Threatening Cardiac Arrhythmias during Anesthesia and Surgery

Abstract

Life-threatening arrhythmias are frequently encountered during anesthesia for cardiac or non-cardiac surgery. They result in a significant cause of morbidity and mortality, particularly in elderly patients. Predisposing factors like electrolytes abnormalities, pre-existing cardiac disease, intubation procedure, anesthetic medications, and various surgical stimulation need to be determined. Early diagnosis and commencement of an appropriate treatment protocol may be lifesaving. Treatment usually involves correction of the underlying causes, cardiac electroversion, and the use of one or more antiarrhythmic agents. Although ventricular tachycardia, ventricular fibrillation, torsade de pointes, and pulseless electrical activity are considered malignant arrhythmias that can lead to cardiac arrest, other types of Brady and tachyarrhythmias are also included in this chapter to enable adopting a more objective approach in the management of arrhythmias intraoperatively, avoiding risks of inappropriate management strategies.

Comparing intensity of pain due to intravenous injection of sodium thiopental, propofol, diazepam, and etomidate during induction of general anesthesia

“…Before induction of anesthesia, the patient undergoes complete monitoring, which includes measurement of blood pressure, electrocardiogram (ECG), measurement of arterial oxygen saturation, and heart rate. [ 1 2 ] Cardiac arrhythmias,[ 1 ] hemodynamic changes,[ 2 3 ] and hypotension[ 3 ] are some of the events that may occur during the induction of anesthesia and endanger the lives of patients who are diagnosed with the help of monitoring, and treated, if necessary. There are various anesthetic drugs and often belong to benzodiazepines (midazolam and diazepam, barbiturates (sodium thiopental, methohexital), propofol, etomidate (Ding et al .…”

“…2021), inhaled anesthetics (isoflurane), neuromuscular relaxants (atracurium), and opioids (fentanyl, sufentanil). [ 1 ] The anesthetic drugs are selected based on the patient’s conditions, induction rate, drug recovery, and mechanism of action of the drug. [ 2 3 ] Propofol, sodium thiopental, etomidate, and diazepam are among the most widely used drugs in general anesthesia.…”