심율동전환을 시행하는 환자에서 정맥마취를 위해 병용한 Midazolam , Fentanyl , Propofol 의 효과

Background: Elective cardioversion is a short procedure performed under amnesia, sedation or anesthesia for the treatment of cardiac dysrhythmia. Midazolam, fentanyl and propofol on hemodynamic changes and side effects were studied. Methods: Thirty patients scheduled for an elective cardioversion in the coronary care unit received propofol 500 μg/kg I.V., followed by a continuous infusion with 25-75 μg/kg/min until they lost consciousness as determined by cessation of response to verbal command. All patients received midazolam 0.02 mg/kg and fentanyl 2 μg/kg I.V. 5 minutes before induction. In addition, the cardiologist administrated the electric shock. Blood pressures and heart rates were measured prior to induction, after the administration of midazolam and fentanyl, after cardioversion, 5 minutes after cardioversion and recovery. The recovery time from terminating drug administration to awakening, and the total dose of propofol were recorded. Patients were observed for side effects. Results: Systolic, mean, and diastolic blood pressures were significantly decreased 5 minutes after cardioversion and recovery. Heart rates were significantly decreased after cardioversion, 5 minutes after cardioversion and recovery. Recovery times were 22.1±14.9 minutes and the total dose of propofol was 0.79±0.39 mg/kg. Incidence of apnea (> 30 s) was 30%. Conclusions: We concluded that midazolam, fentanyl and propofol in patients undergoing an electric cardioversion decreased blood pressure and heart rate, but the cardiovascular status was maintained within clinically acceptable levels. (Korean J Anesthesiol 2001; 41: 284-288)