• Middle East J Anaesthesiol · Oct 2011

    Case Reports

    "Crime scene investigation" at an anesthetic cocktail party with atrioventricular dissociation.

    • Christoph J Schlimp and Franz J Wiedermann.
    • Dept. of Anesthesiology and Critical Care Medicine, Trauma Hospital Klagenfurt, Austria. c.schlimp@gmx.at
    • Middle East J Anaesthesiol. 2011 Oct 1;21(3):409-12.

    AbstractA healthy 21-year-old female patient received midazolam, propofol, fentanyl, rocuronium, nitrous oxide in oxygen, ranitidine, diclofenac, neostigmine and glycopyrrolate during the anesthetic process for elective knee arthroscopy and developed a complete AV dissociation with a P-wave frequency of 40 and a "small" QRS-complex frequency of 55 beats/min. Based on this typical case of poly-pragmatic anesthetic drug administration causing a complete atrioventricular dissociation in a young healthy patient we will discuss the possible pharmacodynamic mechanisms of all used drugs with regard to the cardiac conduction system.

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