This case report highlights the potential for atropine to induce bigeminy when treating bradycardia-dependent ectopy in a pediatric patient during anesthesia.
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Atropine may induce bigeminy when treating bradycardia-dependent ectopy in pediatric anesthesia; hypothesis-generating and should not change practice.
We report the case of a 9-year-old healthy boy who underwent day-surgery herniotomy under combined general and regional anesthesia. After inhalational induction, borderline bradycardia with Premature Ventricular Contractions (PVCs) was observed in ECG tracing, which worsened despite the adequate anesthetic management to avoid and treat arrhythmogenic triggers. Subsequent diagnostic tests were performed to rule out an underlying heart disease. Thereby, we conduct a brief review of ventricular ectopy in children with structurally normal hearts, both in the clinical and perioperative setting; and finally linked to our case in order to find out the cause of the abnormal electrical activity.
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Rebollar et al. (2016) studied this question.
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