Korean J Anesthesiol.  2010 Dec;59(Suppl):S77-S81. 10.4097/kjae.2010.59.S.S77.

Development of multifocal atrial tachycardia in a patient using aminophylline: A case report

• Kim LK
• Lee CS
• Jeun JG

• KMID: 2237358
• DOI: http://doi.org/10.4097/kjae.2010.59.S.S77

Abstract

An 82-year-old female, with left femoral neck fracture was scheduled for left hip hemiarthroplasty, under spinal anaesthesia. She had been suffering from diabetes, hypertension, lung cancer and was previously treated with IV aminophylline for respiratory insufficiency. She was given spinal anaesthesia with 10 mg of 0.5% hyperbaric bupivacaine, and T6 sensory block level was established. After 10 minutes, her blood pressure dropped to 80/60 mmHg, so intravenous ephedrine was given. At that moment, multifocal atrial tachycardia (MAT) appeared on electrocardiogram (ECG). Intravenous infusion of phenylephrine and procainamide was given and conversion of MAT to sinus rhythm was successfully achieved. We report a case of MAT after spinal anaesthesia, in a patient with respiratory insufficiency previously treated with IV aminophylline, which was successfully treated by intravenous infusion of phenylephrine and procainamide.

Keyword

Aminophylline; Multifocal atrial tachycardia; Procainamide; Respiratory insufficiency; Spinal block

MeSH Terms

Aged, 80 and over
Aminophylline
Blood Pressure
Bupivacaine
Electrocardiography
Ephedrine
Female
Femoral Neck Fractures
Hemiarthroplasty
Hip
Humans
Hypertension
Infusions, Intravenous
Lung Neoplasms
Phenylephrine
Procainamide
Respiratory Insufficiency
Stress, Psychological
Tachycardia
Aminophylline
Bupivacaine
Ephedrine
Phenylephrine
Procainamide