Ventricular Arrhythmia during Tracheal Intubation and Extubation under General Anesthesia Possibly Induced by Amisulpride: A Case Report

다국어 초록 (Multilingual Abstract)

We are presenting the first documented case of amisulpride related ventricular arrhythmia during tracheal intubation and extubation under general anesthesia in an 48 year-old female with psychiatric history of chronic schizophrenia who was treated with amisulpride. This case suggests the threshold of perioperative arrhythmia is possibly decreased in patients with long-term antipsychotic medication. So, the potential risk of antipsychotics-induced perioperative arrhythmia should be evaluated, as well as heart rhythm monitoring, prophylactic use of antiarrhythmic drugs, and preoperative adjustment of antipsychotics should be considered.

참고문헌 (Reference)

1 Nelson S, "Torsades de pointes after administration of low-dose aripiprazole" 47 : e11-, 2013

2 Winkel TA, "Sudden death during follow-up after new-onset ventricular tachycardia in vascular surgery patients" 53 : 732-737, 2011

3 Nagy N, "Selective Na(+) /Ca(2+) exchanger inhibition prevents Ca(2+) overload-induced triggered arrhythmias" 171 : 5665-5681, 2014

4 Honkola J, "Psychotropic medications and the risk of sudden cardiac death during an acute coronary event" 33 : 745-751, 2012

5 Hayashi T, "Neuroleptics with differential affinities at dopamine D2 receptors and sigma receptors affect differently the N-methyl-D-aspartate-induced increase in intracellular calcium concentration: involvement of protein kinase" 31 : 20-28, 1999

6 Poveda JJ, "Chronotropic changes and cardiac arrhythmias during anesthetic induction and intubation in patients undergoing heart surgery. Study of 79 patients using Holter monitoring" 39 : 345-348, 1992

7 Pacher P, "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" 10 : 2463-2475, 2004

8 Wu CS, "Antipsychotic drugs and the risk of ventricular arrhythmia and/or sudden cardiac death: a nation-wide case-crossover study" 4 : e001568-, 2015

9 Barbui C, "Antipsychotic dose mediates the association between polypharmacy and corrected QT interval" 11 : e0148212-, 2016

10 Isbister GK, "Amisulpride deliberate self-poisoning causing severe cardiac toxicity including QT prolongation and torsades de pointes" 184 : 354-356, 2006

11 Huang LC, "Amisulpride and symptomatic bradycardia: a case report" 37 : 497-, 2015

12 김용민, "Amisulpride Switching in Schizophrenic Patients Who Showed Suboptimal Effect and/or Tolerability to Current Antipsychotics in a Naturalistic Setting: An Explorative Study" 대한정신약물학회 14 (14): 371-377, 2016

13 Rosenzweig P, "A review of the pharmacokinetics, tolerability and pharmacodynamics of amisulpride in healthy volunteers" 17 : 1-13, 2002