Assessment of the Surgical Patients with Pacemaker

Lee, Byung Ho; Chea, Jun Seuk; Kim, Chang Jae; Chung, Mee Young; Yoon, Jae Won; Min, Jin Hye

Abstract

BACKGROUND
The development of techniques and improvement of diagnostic facilities have led to the increased use of pacemakers in cardiac patients. So, anesthesiologists should have paid more attention to the patients with pacemakers, and they also need the full knowledge of wide varieties of pacemakers currently used for a safety of these patients. The purpose of this study is the assessment of fifteen pacemaker patients undergoing surgery.
METHODS
This study was done in 15 cardiac patients with pacemaker who underwent noncardiac operations. We evaluated symptom, ECG rhythm, underlying cardiac disease before pacemaker implantation and the type of implanted pacemaker. The type and duration of operations, together with anesthetic techniques were also assessed.
RESULTS
The pre-pacemaker symptoms were intermittent dizziness, palpitation, syncope, and general weakness. The underlying cardiac diseases were complete A-V block, sick sinus syndrome and bifascicular block. The types of implanted pacemakers were VVIR (n=14) and DDD (n=1). The kinds of anesthetic techniques were general anesthesia (N2O-O2-enflurane; n=10, N2O-O2-fentanyl; n=1), and continuous epidural block (n=3) or continuous spinal block (n=1) combined with general anesthesia (N2O-O2).
CONCLUSIONS
We should evaluate the patient with pacemakers preoperatively for underlying cardiac disease and implanted pacemaker. Thereafter, we have to choose the safe anesthetic technique.