全身麻酔中に無脈性心室頻拍を来した人工膝関節置換術の1症例

A Case of Pulseless Ventricular Tachycardia during Total Knee Arthroplasty under General Anesthesia

要旨

　硬膜外麻酔併用全身麻酔下の両側人工膝関節置換術中に，無脈性心室頻拍（pulseless ventricular tachycardia：pVT）を生じた症例を経験した。患者は，麻酔導入後より徐々にQT時間が延長し，pVT直前のQT時間が著明に延長していた。pVT直前の心電図にST変化がなかったことから，全身麻酔後に顕在化したQT延長からR on Tが生じ，pVTに至ったと考えられた。

　We report the case of ventricular tachycardia that might be caused by R on T from QT prolongation during general anesthesia combined with epidural anesthesia. After the induction of general anesthesia, QT prolongation occurred this patient and became remarkable before the occurrence of pulseless ventricular tachycardia（pVT）. Since no change of ST-segment was recognized before the pVT occurred, we speculate that the patient’s pVT was caused by the R on T following QT prolongation after general anesthesia.