Anaesthetic management of abdominal hysterectomy in patient with congenital sinus node dysfunction

Dileep Kumar, Faisal Shamim

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

A 45 years old woman having dysfunctional uterine bleeding was scheduled for total abdominal hysterectomy with bilateral salpingo-oophorectomy under general anaesthesia. On pre-operative anaesthesia assessment, she was found to have junctional rhythm at rate of 44 beats/minute with bigeminies and pre-mature ventricular contractions on ECG. On further evaluation, she was diagnosed as having congenital sinus node dysfunction on the basis of 24 hours Holter monitoring. She was asymptomatic, no prior comorbidity and belonged to functional class one. General anaesthesia was successfully managed by vigilance, invasive monitoring, standby transcutaneous and transvenous pacemakers; use of cardiostable and vagolytic anaesthetic agents like Etomidate, Atracurium and Pethidine during the procedure and for postoperative pain management. Transcutaneous external pacing pads were placed just after induction of anaesthesia, their functional capability was confirmed and was ready for use if needed. The transcutaneous and transvenous pacemakers were on backup and both were not required. Patient was successfully managed and was discharged home on third postoperative day with uneventful hospital course. The elective pacemaker implantation was therefore not required.

Original languageEnglish
Pages (from-to)760-762
Number of pages3
JournalJournal of the College of Physicians and Surgeons--Pakistan : JCPSP
Volume21
Issue number12
Publication statusPublished - Dec 2011

Keywords

  • Arrythmias
  • Genaral anaesthesia
  • Pacemaker
  • Sick sinus syndrome
  • Sino-atrial node

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