Right internal jugular vein catheter induced paroxysmal supraventricular tachycardia in 1 case.docVIP

 PAGE \* MERGEFORMAT 4 Right internal jugular vein catheter induced paroxysmal supraventricular tachycardia in 1 case [Keywords:] right internal jugular vein catheterization paroxysmal supraventricular tachycardia Case Description: male patients, aged 27, weight 46kg, preoperative blood, urine, liver and kidney function, chest radiograph, electrocardiogram and other tests, no exceptions. Adequate preoperative preparation, the proposed radical surgery for rectal cancer. Intramuscular injection 30 minutes before surgery luminal sodium 0.1g and atropine 0.5mg, operating room monitoring: blood pressure (BP) 120/72mmHg, heart rate (HR) 100 beats / min, pulse oxygen saturation (SPO2) 96%. anesthetic induction followed by intravenous injection midazolam 5mg, sufentanil 25g, vecuronium 6mg, propofol 100mg, intubation success. to give 0.8% isoflurane and remifentanil 0.08g/kg/min constant speed pumping, maintenance anesthesia. Choose the right sternal head and clavicular head of sternocleidomastoid muscle in the intersection of two inside as the puncture point, avoiding the external jugular vein internal jugular vein. Needle penetration of the internal jugular vein successfully, when monitoring shows that: HR 100 beats / min, BP 95/55mmHg, SpO2 99%. guidewire into the patient heart rate achieved during the 180 beats / min, rhythm and tidy, as supraventricular tachycardia. was considered too shallow for the anesthesia, the operation caused heart rate, stop the operation. given 30mg bolus of propofol, heart rate decreased to 175 beats / min, again propofol 20mg, heart rate decreased to 165 beats / min, BP fell to 85/48mmHg. continue to operate back puncture the process of rapid heart rate and needle increased to 182 beats / min, supraventricular tachycardia remains. At this point to consider is the guide wire on the right atrial wall or the sinus wall near the stimulation of the superior vena cava lead to sinus node and atrial mass atrioventricular node induced t