Abstract
This is a case report of a one year old infant weighing 6.7 kilograms with a preoperative diagnosis of partial anomalous pulmonary venous drainage whose anaesthetic was complicated by cardiovascular collapse following addition of nitrous oxide to oxygen administered to the patient using a T-piece breathing circuit. The cardiovascular pathopharmacology of all the drugs administered to the patient before the event as well as that of nitrous oxide is discussed in detail. The drugs discussed are atropine 0.1 mg (0.01 mg·kg-1), glycopyrrolate 0.07 mg (0.01 mg·kg-1), morphine 0.9 mg (0.14 mg·kg-1) methylprednisone sodium succinate 165 mg (23.5 mg·kg-1) sodium thiopentone 40 mg (5.7 mg·kg-1), metocurine 3.4 mg (0.4 mg·kg-1).
Résumé
Un enfant âgé d’un an et pesant 6.7 kg a présenté au cours d’une anesthésie, avant le début de la chirurgie (correction d’un retour veineux pulmonaire anormal partiel), un collapsus cardiovasculaire. Cette complication est survenue après l’addition de protoxyde d’azote à l’oxygène inhalé dans une pièce en T. Les effets cardiovasculaires de tous les agents utilisés avant cet accident ainsi que ceux du protoxyde d’azote lui-même sont discutés dans le contexte de ce cas particulier. Les agents en cause étaient l’atropine à la dose de 0.1 mg (0.01 mg·kg-1), le glycopyrrolate à la dose de 0.07 mg (0.01 mg·kg-1), la morphine (dose utilisée: 0.9 mg, soit 0.14 mg·kg-1), le succinate sodique de méthylprednisone (dose: 165 mg, soit 23.5 mg·kg-1), le thiopentone (40 mg, i.e. 5.7 mg·kg·-1) et la méthocurine (3.4 mg. soit 0.5 mg·kg-1).
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Davidson, J.R., Chinyanga, H.M. Cardiovascular collapse associated with nitrous oxide anaesthetic: A case report. Canad. Anaesth. Soc. J. 29, 484–488 (1982). https://doi.org/10.1007/BF03009414
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DOI: https://doi.org/10.1007/BF03009414