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Canadian Journal of Anesthesia 51:806-809 (2004)
© Canadian Anesthesiologists' Society, 2004
General Anesthesia

Bradycardie sévère et asystolie lors d’induction au sévoflurane et sufentanil à faible dose : à propos de trois cas

[Low dose sufentanil and severe bradycardia during induction with sevoflurane: a report of three cases]

Valérie Cardinal, MD, René Martin, MD FRCPC, Jean-Pierre Tétrault, MD MSc FRCP, Marie-José Colas, MD FRCPC, Linda Gagnon, MD FRCPC and Yves Claprood, MD FRCPC

Du Département d’anesthésiologie, Université de Sherbrooke, Sherbrooke, Québec, Canada.

Adresser la correspondance à: Dr Valérie Cardinal, Département d’anesthésiologie, CHUS, 3001 12e avenue nord, Sherbrooke, Québec J1H 5N4, Canada. Téléphone : 819-346-1110, poste 14403; Télécopieur : 819-820-6413; Courriel : lise.gilbert{at}usherbrooke.ca

Objectives: In a randomized double blind clinical study using low doses of fentanyl or sufentanil during sevoflurane induction, we observed three cases of severe bradycardia, forcing us to discontinue the study. We wish to describe these three cases.

Clinical data: Anesthesia was induced in the three patients, using a single breath technique consisting of a mixture of sevoflurane 8% with a nitrous oxide flow of 3 L·min–1 and an oxygen flow of 3 L·min–1. After the patients had lost consciousness, low dose sufentanil was administered (0.025 µg·kg–1 for the first patient and 0.1 µg·kg–1 for the other two patients). Heart rate fell to 38, 40 and 42 beats·min–1 respectively two minutes after the sufentanil injection in these three patients, and progressed to asystole in the third. All the patients responded to atropine 0.6 mg iv.

Conclusion: The addition of sufentanil, even at very low doses, during anesthesia induction with sevoflurane using a single breath technique, may be dangerous because of possible bradycardia and even asystole.






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