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Canadian Journal of Anesthesia 48:305-307 (2001)
© Canadian Anesthesiologists' Society, 2001
Cardiothoracic Anesthesia, Respiration and Airway

Asystole after intravenous neostigmine in a heart transplant recipient

Richard J. Bjerke, MD and Michael P. Mangione, MD

From the Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Address correspondence to: Dr. Richard J. Bjerke, Anesthesia Service, VA Pittsburgh Health Care System, University Drive C, Pittsburgh, PA 15240 USA. Phone: 412-688-6152; Fax: 412-688-6906; E-mail: bjerkerj{at}anes.upmc.edu

Objectif : Décrire le cas d'un receveur de greffe cardiaque qui a développé une asystole après l'administration de néostigmine, ce qui laisse croire que la dénervation cardiaque ne préviendrait pas de façon permanente des réactions significatives aux anticholinestérases.

Éléments cliniques : Un homme de 67 ans, receveur d'une greffe cardiaque 11 ans plus tôt, a subi une lobectomie pulmonaire supérieure gauche. Il a développé une asystole après l'administration intraveineuse de 4 mg de néostigmine et de 0,8 mg de glycopyrrolate pour renverser l'effet du myorelaxant. Il n'a jamais présenté quelque anomalie de la fréquence ou du rythme cardiaque que ce soit avant ou après l'incident.

Conclusion : Quand on administre une médication anticholinestérasique aux patients receveurs de greffe cardiaque, il faut être prêt, malgré une dénervation chirurgicale, à faire face à une réponse cardiaque marquée possible.




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Successful use of remifentanil for major head and neck surgery in a heart-lung transplant recipient
Br. J. Anaesth., September 1, 2004; 93(3): 473 - 474.
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This Article
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Copyright © 2001 by the Canadian Anesthesiologists' Society.