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[Transient right bundle branch block during anesthesia].

Shino Umehara1, Makoto Tanaka, Toshiaki Nishikawa

  • 1Department of Anesthesiology, Akita University School of Medicine, Akita.

Masui. the Japanese Journal of Anesthesiology
|June 22, 2005
PubMed
Summary
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Sevoflurane anesthesia can cause transient right bundle branch block. This case study shows complete right bundle branch block (CRBBB) was dependent on heart rate during surgery.

Area of Science:

  • Anesthesiology
  • Cardiology
  • Electrophysiology

Background:

  • Transient right bundle branch block is an occasional complication during anesthesia.
  • Preoperative electrocardiogram (ECG) in this patient showed no conduction abnormalities.

Observation:

  • A 74-year-old male developed complete right bundle branch block (CRBBB) 5 hours into sevoflurane anesthesia for partial hepatectomy.
  • The CRBBB occurred gradually without hemodynamic changes and persisted throughout the surgery.
  • Ventricular conduction changes correlated with heart rate fluctuations.

Findings:

  • The patient's CRBBB resolved 8 hours post-surgery, with a normal ECG.
  • Serum creatine phosphokinase (CPK) isoenzyme levels remained within normal limits.
  • The transient CRBBB was determined to be rate-dependent.

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Implications:

  • This case highlights the potential for rate-dependent CRBBB under sevoflurane anesthesia.
  • Awareness of this phenomenon is crucial for anesthesiologists to monitor cardiac conduction.
  • Further studies may elucidate the precise mechanisms of anesthetic-induced conduction abnormalities.