척추측만증이 있는 개에서 안구후방마취 후 발생된 안구심장반사 1례 (Oculocardiac Reflex Caused by Retrobulbar Block in a Dog with Scoliosis)

서지정보

· 발행기관 : 한국임상수의학회
· 수록지 정보 : 한국임상수의학회지 / 26권 / 5호 / 476 ~ 479페이지
· 저자명 : 박영우, 손원균, 김세은, 서강문, 이인형

초록

Enucleation of a 9-year-old, spayed female Pekingese's right eye was scheduled because of recurrent eyeball
rupture caused by chronic corneal ulcer and descemetocele. Scoliosis of the thoracic vertebra was observed on thoracic
radiography. Complete blood count, electrolytes, serum chemistry profiles were within normal ranges except of alkaline
phosphatase, which was markedly improved, compared with that of five months ago. Severe respiratory sinus arrhythmia
was observed before induction of anesthesia, it disappeared after induction. Retrobulbar block was performed with
0.5% bupivacaine, 2% lidocaine, 0.1% epinephrine combination (4 : 1 : 0.2 ratio of volume) before start of surgery.
After retrobulbar block, heart rate decreased from 110 to 76 beats/min and sinus arrhythmia recurred. It was considered
as oculocardiac reflex caused by increase of intraorbital pressure from retrobulbar block, atropine (0.025 mg/kg, Ⅳ)
was administered and intermittent positive pressure ventilation was started. Three minutes after atropine administration,
abnormal waveform of the electrocardiograph was appeared, it suspected as ventricular or supraventricular tachycardia,
so lidocaine (2 mg/kg, Ⅳ) was administered. Then, heart rate was maintained around 130 beats/min, and the surgery
was finished without the other problems. Although, retrobulbar block is performed to provide analgesia and to prevent
oculocardiac reflex in ophthalmic surgery, occasionally it could induce oculocardiac reflex by infiltrated volume.

영어초록

Enucleation of a 9-year-old, spayed female Pekingese's right eye was scheduled because of recurrent eyeball
rupture caused by chronic corneal ulcer and descemetocele. Scoliosis of the thoracic vertebra was observed on thoracic
radiography. Complete blood count, electrolytes, serum chemistry profiles were within normal ranges except of alkaline
phosphatase, which was markedly improved, compared with that of five months ago. Severe respiratory sinus arrhythmia
was observed before induction of anesthesia, it disappeared after induction. Retrobulbar block was performed with
0.5% bupivacaine, 2% lidocaine, 0.1% epinephrine combination (4 : 1 : 0.2 ratio of volume) before start of surgery.
After retrobulbar block, heart rate decreased from 110 to 76 beats/min and sinus arrhythmia recurred. It was considered
as oculocardiac reflex caused by increase of intraorbital pressure from retrobulbar block, atropine (0.025 mg/kg, Ⅳ)
was administered and intermittent positive pressure ventilation was started. Three minutes after atropine administration,
abnormal waveform of the electrocardiograph was appeared, it suspected as ventricular or supraventricular tachycardia,
so lidocaine (2 mg/kg, Ⅳ) was administered. Then, heart rate was maintained around 130 beats/min, and the surgery
was finished without the other problems. Although, retrobulbar block is performed to provide analgesia and to prevent
oculocardiac reflex in ophthalmic surgery, occasionally it could induce oculocardiac reflex by infiltrated volume.

참고자료

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