Ventricular cardiac arrhythmias during anesthesia: feasibility of preoperative recognition

We investigated the occurrence of anesthetic ventricular cardiac arrhythmia (CA) in 104 systemically healthy consecutive patients undergoing general anesthesia, to evaluate the possibility of recognizing preoperatively those patients prone to CA. In 19 (18%) patients, control strips taken before anesthesia showed CA. During anesthesia CA developed in 34 (33%), including 16 during induction, ten during endotracheal intubation, and eight during both events. Older patients had a higher incidence of CA than younger ones (P less than 0.01), and patients with preoperative CA showed a greater trend toward anesthetic CA. There were no anesthetic deaths in this group. Early detection and treatment avoided complications and sequelae of CA. A second anesthetist in the operating room, to monitor the cardiac rhythm during induction and intubation, possibly contributed to early detection of CA and is strongly recommended.