• T Saishu, N Iwatsuki, T Tajima, and Y Hashimoto.
• Department of Anesthesiology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, 980, Sendai, Japan.
• J Anesth. 1994 Sep 1;8(3):284-7.

AbstractThe effect of intravenously administered flecainide on premature supraventricular (PSCs) and ventricular contractions (PVCs) which developed under general anesthesia was evaluated. Flecainide was infused intravenously at a rate of 0.2 mg/kg/min until the efficacy of this drug appeared or for 10 min; thus, the maximum dose was determined to be 2 mg/kg. Flecainide was administered to 10 patients who experienced more than 5 supraventricular and/or ventricular contractions/min for a period of more than 5 min (PVCs, 4 patients; PSCs, 6 patients). PVCs in 4/4 cases and PSCs in 5/6 cases disappeared following administration of flecainide. The average dose of flecainide was 1.08±0.17 mg/kg (SE). This dose of flecainide did not affect the heart rate and QRS interval, but caused a transient decrease in systolic blood pressure from 127±6 mmHg (SE) to 114±6 mmHg, a 14% increase in the PQ interval, and a 6.3% increase in the QT interval. These results suggest that flecainide is a promising drug for the treatment of PSCs and PVCs which develop during general anesthesia. Transient hypotension and cardiac conduction disturbances immediately after injection may occur when flecainide is used intravenously.

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