Conversion of supraventricular arrhythmia to normal rhythm by propofol and remifentanil: three cases report
A 71-year-old male with a history of hydrocephalus was admitted to the hospital for surgery of ventriculoperitoneal shunt. The patient had a history of hypertension, arrhythmia, cerebral infarction 10 years previously and was taking oral medications for hypertension (the name of medication was unknown). The patient had a history of unidentified arrhythmia, but he did not have cardiac symptoms; the patient was not taking antiarrhythmic drugs. A preoperative ECG showed frequent (70-80 /min) premature atrial contractions. Transthoracic echocardiographic findings were not remarkable. Laboratory results including electrolytes and cardiac enzymes were also normal. The patient was not premedicated. Prior to anesthetic induction, the patient's blood pressure was 100/60 mmHg, heart rate was 65 beats/min, and standard ECG lead II showed the same arrhythmia. Anesthesia was induced and maintained with propofol and remifentanil using TCI, and an oxygen-air mixture (FiO2 = 0.5). Rocuronium 40 mg was administered intravenously, and trachea was intubated. Ten minutes later, the patient's ECG converted to NSR, which was persistent on postoperative day 1. However, the NSR reverted to his preoperative cardiac rhythm thereafter.