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Canadian Journal of Anesthesia, Vol 42, 404-408, Copyright © 1995 by Canadian Anesthesiologists' Society

ARTICLES

Anaesthetic induction in a child with end-stage cardiomyopathy

WS Schechter, C Kim, M Martinez, BF Gleason, DP Lund and FA Burrows
Department of Anesthesia, Children's Hospital, Boston, MA 02115, USA.

The purpose of this clinical report is to discuss the anaesthetic management of a patient with end-stage cardiomyopathy. An eight-year-old boy sustained electro-mechanical dissociation following a "standard anaesthetic induction" but was subsequently successfully anaesthetized using a combination of etomidate, midazolam, lidocaine, vecuronium and glycopyrrolate. Anaesthetic techniques and their relationship to the specific category of cardiomyopathy (dilated, hypertrophic or restrictive) are discussed. The potential detrimental effects of anaesthetic sympatholysis, myocardial depression and negative chronotropy on cardiac output are explained.




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Copyright © 1995 by the Canadian Anesthesiologists' Society.