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Dexmedetomidine-induced atrioventricular block followed by cardiac arrest during atrial pacing: a case report and review of the literature

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Abstract

Sinus bradycardia is a well-known consequence of stimulation of presynaptic α2 adrenergic receptors due the adminstration of dexmedetomidine. One of the most serious adverse effects of dexmedetomidine is cardiac arrest. Some cases demonstrating such an arrest due to the indiscriminate use of this drug were recently reported. We continuously administered dexmedetomidine to a 56-year-old male patient at a rate of 0.3 μg/kg/h (lower than the recommended dose) without initial dosing for sedation in an intensive care unit. The patient had undergone open cardiac surgery and atrial pacing was maintained at a fixed rate, 90/min. The PQ interval in electrocardiography gradually prolonged during the infusion; finally, complete atrioventricular block and subsequent cardiac arrest occurred. Immediate cardiopulmonary resuscitation was carried out, including re-intubation, and recovery of spontaneous circulation was attained 15 min after the event. The patient was discharged from hospital on the 25th postoperative day without any neurological complications.

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Conflict of interest

None of the authors of this report has any conflict of interest.

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Authors and Affiliations

  1. Department of Anesthesia, Japanese Red Cross Hamamatsu Hospital, Hamamatsu, Shizuoka, 4348533, Japan

    Kotaro Takata

  2. Department of Emergency Medicine, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan

    Yushi U. Adachi

  3. Department of Anesthesia, Enshu Hospital, Hamamatsu, Shizuoka, 4300929, Japan

    Katsumi Suzuki

  4. Intensive Care Unit, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 4313192, Japan

    Yukako Obata & Shigehito Sato

  5. Department of Anesthesiology and Resuscitation, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 4668550, Japan

    Kimitoshi Nishiwaki

Authors
  1. Kotaro Takata
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  2. Yushi U. Adachi
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  3. Katsumi Suzuki
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  4. Yukako Obata
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  5. Shigehito Sato
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  6. Kimitoshi Nishiwaki
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Corresponding author

Correspondence to Yushi U. Adachi.

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Takata, K., Adachi, Y.U., Suzuki, K. et al. Dexmedetomidine-induced atrioventricular block followed by cardiac arrest during atrial pacing: a case report and review of the literature. J Anesth 28, 116–120 (2014). https://doi.org/10.1007/s00540-013-1676-7

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  • DOI: https://doi.org/10.1007/s00540-013-1676-7

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