[Transient complete left bundle branch block during epidural anesthesia with mepivacaine]. 1996

Y Asao, and M Matsumoto, and M Wake, and Y Hirai
Department of Anesthesia, Kobe West Municipal Hospital, Japan.

A 65-year-old woman with ovarian tumor was scheduled for abdominal total hysterectomy and bilateral adnexectomy under epidural anesthesia. Preoperative examinations revealed no abnormalities including ECG. Twenty minites after the epidural injection of mepivacaine, widened QRS complexes, which were diagnosed as complete left bundle branch block (CLBBB) later, appeared on ECG. At that time, heart rate (HR) was 150.min-1. CLBBB disappeared when HR decreased to 110.min-1 following the administration of pindolol and verapamil. The operation was postponed. Exercise-treated ECG showed neither CLBBB nor ischemic change even when HR increased to 160.min-1. Two weeks later the operation was attempted again. CLBBB appeared again twenty minites after the epidural injection of mepivacaine. The CLBBB disappeared 5 minites after the induction of general anesthesia when HR decreased to 100.min-1. The operation was performed uneventfully. The effective refractory period (ERP) is shortened with the increase in HR, but the shortning of ERP varies in different part of the cardiac conduction system. In tachycardia, ERP of left bundle branch is longer than that of right one. Because the cardiac conduction system is depressed by local anesthetics, it is speculated that ERP of left bundle branch is elongated further by mepivacaine and CLBBB appeared in this case.

UI MeSH Term Description Entries
D008619 Mepivacaine A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168) Carbocaine,Carbocaïne,Isocaine,Isogaine,Meaverin,Mecain,Mepihexal,Mepivacain-Injektopas,Mepivacaina Braun,Mepivacaine Hydrochloride,Mepivacaine Monohydrochloride,Mepivastesin,Polocaine,Scandicain,Scandicaine,Scandinibsa,Scandonest,Mepivacain Injektopas
D010051 Ovarian Neoplasms Tumors or cancer of the OVARY. These neoplasms can be benign or malignant. They are classified according to the tissue of origin, such as the surface EPITHELIUM, the stromal endocrine cells, and the totipotent GERM CELLS. Cancer of Ovary,Ovarian Cancer,Cancer of the Ovary,Neoplasms, Ovarian,Ovary Cancer,Ovary Neoplasms,Cancer, Ovarian,Cancer, Ovary,Cancers, Ovarian,Cancers, Ovary,Neoplasm, Ovarian,Neoplasm, Ovary,Neoplasms, Ovary,Ovarian Cancers,Ovarian Neoplasm,Ovary Cancers,Ovary Neoplasm
D002037 Bundle-Branch Block A form of heart block in which the electrical stimulation of HEART VENTRICLES is interrupted at either one of the branches of BUNDLE OF HIS thus preventing the simultaneous depolarization of the two ventricles. Fascicular Block,Anterior Fascicular Block,Bundle Branch Block,Left Bundle-Branch Block,Posterior Fascicular Block,Right Bundle-Branch Block,Anterior Fascicular Blocks,Block, Anterior Fascicular,Block, Bundle Branch,Block, Bundle-Branch,Block, Fascicular,Block, Left Bundle-Branch,Block, Posterior Fascicular,Block, Right Bundle-Branch,Blocks, Anterior Fascicular,Blocks, Bundle Branch,Blocks, Bundle-Branch,Blocks, Fascicular,Blocks, Left Bundle-Branch,Blocks, Posterior Fascicular,Blocks, Right Bundle-Branch,Branch Block, Bundle,Branch Blocks, Bundle,Bundle Branch Blocks,Bundle-Branch Block, Left,Bundle-Branch Block, Right,Bundle-Branch Blocks,Bundle-Branch Blocks, Left,Bundle-Branch Blocks, Right,Fascicular Block, Anterior,Fascicular Block, Posterior,Fascicular Blocks,Fascicular Blocks, Anterior,Fascicular Blocks, Posterior,Left Bundle Branch Block,Left Bundle-Branch Blocks,Posterior Fascicular Blocks,Right Bundle Branch Block,Right Bundle-Branch Blocks
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000767 Anesthesia, Epidural Procedure in which an anesthetic is injected into the epidural space. Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D000779 Anesthetics, Local Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate. Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics

Related Publications

Y Asao, and M Matsumoto, and M Wake, and Y Hirai
November 1979, Anesthesiology,
Y Asao, and M Matsumoto, and M Wake, and Y Hirai
September 1984, Masui. The Japanese journal of anesthesiology,
Y Asao, and M Matsumoto, and M Wake, and Y Hirai
December 2004, Masui. The Japanese journal of anesthesiology,
Y Asao, and M Matsumoto, and M Wake, and Y Hirai
September 2021, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology,
Y Asao, and M Matsumoto, and M Wake, and Y Hirai
January 1972, Anesthesia and analgesia,
Y Asao, and M Matsumoto, and M Wake, and Y Hirai
June 2005, Masui. The Japanese journal of anesthesiology,
Y Asao, and M Matsumoto, and M Wake, and Y Hirai
July 1988, Masui. The Japanese journal of anesthesiology,
Y Asao, and M Matsumoto, and M Wake, and Y Hirai
August 1980, Anesthesia and analgesia,
Y Asao, and M Matsumoto, and M Wake, and Y Hirai
January 1966, Kardiologia polska,
Y Asao, and M Matsumoto, and M Wake, and Y Hirai
January 2019, Journal of electrocardiology,
Copied contents to your clipboard!