전이성 척추 종양제거를 위한 전신마취중 발생한 갑작스런 심정지 1예 = A Sudden Cardiac Arrest during General Anesthesia for treatment of Spine Tumor

다국어 초록 (Multilingual Abstract)

A 70-year-old, 30㎏ woman who wats emaciated, presented for metastatic T6 spine tumor removal. She had a subtotal gastrectomy and chemotherapy one year ago. She was premedicated with Glycopyrolate and a general anesthetic technique planned. Directed arterial blood pressure, electrocardiograph and pulse oximetry monitoring were established before induction of anesthesia with alfentanil, thiopental sodium. succinylcholine. Anesthesia was maintained with enflurane in oxygen and nitrous oxide and muscle relaxation facilitated with atracurium.
Approximately 4hrs after initiation of induction of anesthesia, the surgeon sutured subcutaneous layer. Precisely at this time, the attendant anesthetist immediately noticed the arterial trace become flat lines with bradycardia. Resuscitation commenced with atropine injection and 100% oxygen administered by hand ventilation and external cardiac compression producing a systolic blood pressure of 30-50㎜Hg. After 1㎖(1㎎) of adrenaline 1:1000 followed by 1.0 mg atropine was given intravenously, external defibrillation of 300~joule was applied twice. After VF and VT, sinus rhythm returned with a pulse of 106 bpm and a blood pressure of 80/40㎜Hg. The patient appeared to have returned to pre-arrest concious level and no adverse effect with a cardiology consultation. On post-op 3 day, he was died with septic shock and multi-organ failure.