Korean J Anesthesiol.  2005 Feb;48(2):198-201. 10.4097/kjae.2005.48.2.198.

Paroxysmal Supraventricular Tachycardia Treated with Esmolol before Anesthesia Induction: A case report

• Park CH
• Kil TY
• Chung JY
• Roh WS
• Kim BI
• Cho SK

• KMID: 2238386
• DOI: http://doi.org/10.4097/kjae.2005.48.2.198

Abstract

We describe the case of a 61-year-old woman who manifested with paroxysmal supraventricular tachycardia (PSVT). She was scheduled with gastrectomy and partial hepatectomy because of stomach cancer metastasis. EKG findings were normal in the preoperative period but she had symptoms of palpitation, restlessness, and a high systolic blood pressure (180 mmHg) in the operating room before anesthesia induction. On her EKGs, we recognized a PSVT characterized by a high pulse rate of 180 beats per minute, a narrow QRS complex of 40 msec, and no P wave. These findings were not terminated by carotid massage or antiarrhythmics (verapamil and lidocaine), but were completely treated by the beta-blocker, esmolol. We consider that esmolol is a good choice for the treatment of PSVT with a narrow QRS complex combined with a high blood pressure in case with known hypertension or that have experienced preoperative anxiety or stress.

Keyword

supraventricular tachycardia; antiarrhythmics; esmolol

MeSH Terms

Anesthesia*
Anxiety
Blood Pressure
Electrocardiography
Female
Gastrectomy
Heart Rate
Hepatectomy
Humans
Hypertension
Massage
Middle Aged
Neoplasm Metastasis
Operating Rooms
Preoperative Period
Psychomotor Agitation
Stomach Neoplasms
Tachycardia, Supraventricular*