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- Title
Complete atrioventricular block under epidural ropivacaine infusion in a patient with first-degree atrioventricular block and myasthenia gravis: a case report.
- Authors
Hashimoto, Takuma; Kuratomi, Shinobu; Yoshimura, Hayashi
- Abstract
Background: First-degree atrioventricular block (AVB) may lead to complete AVB. Herein, we present a case of a complete AVB under thoracic epidural catheter infusion of ropivacaine with fentanyl in a patient with first-degree AVB and myasthenia gravis. Case presentation: A 74-year-old woman with first-degree AVB underwent thymectomy for myasthenia gravis. Continuous thoracic epidural catheter infusion of 0.2% ropivacaine with fentanyl was initiated at 15 min before the end of the surgery. At 9 h postoperatively, the electrocardiogram showed a 10-s-long pause due to complete AVB. Thus, a temporary pacemaker was implanted, and at 19 h postoperatively on postoperative day 1, cardiac pacing was initiated and lasted approximately 30 s. After catheter removal, she had no further episodes of complete AVB. Conclusion: First-degree AVB may lead to complete AVB under the influence of thoracic epidural infusion of ropivacaine in patients with myasthenia gravis.
- Subjects
ROPIVACAINE; EPIDURAL catheters; CARDIAC pacing; MYASTHENIA gravis; EPIDURAL anesthesia; FENTANYL
- Publication
JA Clinical Reports, 2022, Vol 8, Issue 1, p1
- ISSN
2363-9024
- Publication type
Case Study
- DOI
10.1186/s40981-022-00524-5