Paradoxical heart rate decrease after ephedrine injection during cesarean section under spinal anesthesia

Takazawa, Tomonori

doi:10.1093/bja/el_12990

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2021

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“…In such cases, IV lidocaine can terminate the arrhythmia and restore normal sinus rhythm 2,4 . We speculate that ephedrine triggered AF through similar mechanisms 5 …”

Section: Introductionmentioning

confidence: 91%

Atrial fibrillation secondary to ephedrine administration and responsive to lidocaine in a Shiloh shepherd dog

Martin‐Flores

Piscitell

Kornreich

2021

Vet Record Case Reports

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A 6‐year‐old, 43 kg, male Shiloh shepherd dog was anaesthetised for computed tomography to investigate the source of respiratory distress, lethargy and decreased appetite. Arterial hypotension during anaesthesia was treated with an infusion of phenylephrine and a bolus of ephedrine, 0.05 mg/kg intravenously (IV). Ephedrine resulted in increased blood pressure and reflexive bradycardia; atrial fibrillation developed immediately after. Approximately 10 minutes later, a bolus of lidocaine 2 mg/kg IV was administered, and normal sinus rhythm was restored within 1 minute. Lone atrial fibrillation may be triggered by agents or disease processes that increase vagal activity. While lidocaine has historically been used only to treat unstable ventricular dysrhythmias, it is effective for terminating this particular type of atrial fibrillation.

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“…In such cases, IV lidocaine can terminate the arrhythmia and restore normal sinus rhythm 2,4 . We speculate that ephedrine triggered AF through similar mechanisms 5 …”

Section: Introductionmentioning

confidence: 91%