デクスメデトミジン投与中にモビッツⅡ型2度房室ブロックから一過性の心静止を来した1症例

Dexmedetomidine induced Second-degree Atrioventricular Block followed by Transient Cardiac Arrest：Case Report

要旨

　気管挿管中の鎮静・鎮痛目的にプロポフォール，フェンタニルに加えデクスメデトミジンを投与したところ，モビッツⅡ型2度房室ブロックから心静止となった症例を経験した。デクスメデトミジン投与中に新たな房室ブロックが出現した際には，早急に投与を中止し，心静止の危険が伴う場合にはアトロピンやドブタミンの投与を考慮する。

　A 71-year-old Japanese man with asymptomatic first-degree AV block underwent emergent hemostatic surgery after 2 thoracic endovascular aortic repairs with two aortic arch vessels and was admitted to the intensive care unit. The patient was intubated and initially received propofol and fentanyl for sedation and analgesia. Dexmedetomidine was added due to body motion. A second-degree atrioventricular block appeared after 4h of dexmedetomidine administration, and the patient was changed to cardiac arrest. Soon after an administration of atropine, sinus rhythm appeared. We should be aware that dexmedetomidine has a high risk of cardiac arrest for to the patients who have atrioventricular block.