Tachycardia

 

What is it

·     Sinus tachycardia

·     Tachyarrhythmia: AF, AFL, SVT, VT

Causes

Common:

·     Inadequate anaesthetic

·     Urinary retention

·     Tourniquet

Deadly:

·     Sepsis

·     Myocardial ischaemia

·     Anaphylaxis

·     Malignant hyperthermia

Assessment

·     Monitor: BP, SpO2, temp

·     Ventilator: CO2 trace, Paw

·     Surgical field: stimulation, blood loss

·     Other: urine catheter

Treatment

·     Pause operating

·     Propofol

·     Opioid

·     ±Beta blocker

 

Bradycardia

What is it

·     Sinus bradycardia

·     Bradyarrhythmia: especially AV block

Causes

Common:

·     Vagal stimulation

·     Bezold-Jarisch response

Deadly:

·     Myocardial ischaemia

·     Cerebral ischaemia

Assessment

·     Monitor: BP, SpO2

·     Surgical field: e.g. insufflation

Treatment

·     Pause operating (exsufflate if applicable)

·     Atropine 600mcg q1min, max 3mg

·     Adrenaline 20mg q1min

·     Transcutaneous pacing: pads A-P, current 70-120mA