静脈内鎮静法下で2%塩酸リドカイン(1/20万エピネフリン含有)により心室性期外収縮を認めた高齢歯科患者の1症例

This reports a case of Trigemmy 5 minutes from the beginning of administration of 1/200,000 epinephrine in 2% Lidocame Hydrochlonde in preparation for tooth extraction in an aged dental patient with circulatory complaints at intravenous sedation. The electrocardiogram before operation indicated previous heart infarction (ST elevation, Abnormal Q wave, Left ventricular hypertrophy) of the 77-year old, male. As anesthetic premedication, 12 mg of Diazepam was administered orally. When the patient was admitted to the operating room, he was sedated well, but these were signs of premature ventricular contraction (PVC), five times/mm. Diazepam was administered intravenously (6 mg/3 mins), and sedation was achieved. Trigemmy continued for 4 minutes trom 5 minutes after the administration of 40μg epinephrine Lidocame Hydrochloride was administered (10 mg×5 times) intravenously for arrhythmia Tngeminy disappeared, but these was sporadic PVC (16 times/min), PVC occurred once a min 2 hours after the end of the operation. The epmephrme (40 μg) gave rise to occurred arrhythmia in spite of safe injection speed and safe dosage. This suggests a desirable dosage of epinephrme of less than 30 jug for aged dental patients with circulatory complaints. It is also suggests that dentists should pay attention to relax patients when using premedication or sedation to ensure the effect of the treatment