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Why the phantom p-wave during general anesthesia?
Nurse Anesthesia
|September 1, 1990
Summary
Hypocarbia, or low carbon dioxide levels, may promote atrioventricular junctional rhythm (AVJR) during general anesthesia. This study found no AVJR during normocarbia but significant incidences during hypocarbia in patients receiving isoflurane-N2O or opioid-N2O anesthesia.
Area of Science:
- Anesthesiology
- Cardiology
- Physiology
Background:
- Atrioventricular junctional rhythm (AVJR) is common during general anesthesia.
- The underlying causes of AVJR remain unclear.
- This study investigated the role of hypocarbia in AVJR development.
Purpose of the Study:
- To test the hypothesis that hypocarbia promotes atrioventricular junctional rhythm (AVJR).
- To investigate the incidence of AVJR under different anesthetic techniques during hypocarbia.
Main Methods:
- One hundred adult patients (ASA Class I) were studied.
- Patients received either isoflurane-N2O or opioid-N2O anesthesia.
- Hyperventilation to induce hypocarbia (20-25 mm Hg end-tidal CO2) was performed, and electrocardiograms monitored for AVJR.
Main Results:
- No patients developed AVJR during normocarbia.
- Incidences of AVJR were 18% with isoflurane-N2O and 26% with opioid-N2O anesthesia during hypocarbia.
- These incidences were statistically significant.
Conclusions:
- Hypocarbia appears to promote atrioventricular junctional rhythm (AVJR) during general anesthesia.
- The findings suggest a link between low carbon dioxide levels and the development of AVJR.
- Further research is warranted to elucidate the precise mechanisms.