Laparoscopic cholecystectomy in the intravenous magnesium ATP severe arrhythmia caused by rapid clinical analysis of 6 cases.docVIP

 PAGE \* MERGEFORMAT 6 Laparoscopic cholecystectomy in the intravenous magnesium ATP severe arrhythmia caused by rapid clinical analysis of 6 cases [Keywords:] laparoscopic cholecystectomy; ATP magnesium chloride; severe arrhythmia laparoscopic cholecystectomy, the CO2 pneumoperitoneum in a sharp increase in blood pressure, increased risk of anesthesia, and intraoperative intravenous infusion of magnesium ATP directly stretch of vascular smooth muscle, reducing peripheral resistance, the role of rapid and reliable blood pressure, short duration, control, and no drug resistance and rapid rebound hypertension and other features, so that intraoperative blood pressure steadily through the perioperative period. But intravenous infusion of ATP can lead to serious arrhythmia excessive magnesium chloride. now I encountered such an accident and the hospital clinical symptoms and treatment is as follows. The clinical data of six cases of a laparoscopic cholecystectomy (LC) patients, 2 males and 4 females, weighing 47 ~ 65 kg, due to cholecystitis and gallstones under general anesthesia during laparoscopic cholecystectomy. Of which 4 were 1 to 2 hypertension, ECG examination was normal, other tests were normal, into the operating room after induction of anesthesia with fentanyl 0.2 mg, propofol 150 ~ 160 mg, 25 mg intravenous card rather muscular tube inserted after induction tube to PEEP, VT 9 ~ 10 ml / kg, RR 12 ~ 14 times / min, inspiratory to expiratory ratio 1:2, PetCO2 maintained at 30 ~ 35 mm Hg, with fentanyl 1 ~ 2 g / (kg min), propofol 3 ~ 4 mg / (kg h) rate of intravenous infusion, intermittent muscle rather give card 12.5 ~ 25 mg, sodium chloride (250 ml 5% glucose solution plus ATP magnesium chloride 2 ), CO2 pneumoperitoneum (pressure 12 mm Hg) to raise intra-abdominal pressure is increased and the diaphragm, so that high blood pressure, by the induction of anesthesia, intubation, 80 ~ 100/50 ~ 80 mm Hg rose to ~ 140 ~ 170/90 120 mm Hg, rapid int