Sevoflurane and lignocaine can trigger complete atrioventricular block in pediatric patients with pre-existing impaired cardiac conduction, highlighting the need for caution with these agents.
May warrant caution with these agents in children with conduction abnormalities; hypothesis-generating and leaves open broader applicability.
We describe the appearance of complete atrioventricular block (CAVB) with sevoflurane and nitrous oxide during the slow induction in a ten-year-old male patient with hypertension, renal dysfunction, and impaired cardiac conduction. Sinus rhythm was restored following the washout of the anaesthetic gas. And CAVB recurred after the subcutaneous injection of lignocaine. The present report shows that sevoflurane should be treated with care like other inhalational anaesthetics as regards the effect on cardiac conduction.
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Maruyama et al. (1998) studied this question.
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