Ventricular tachycardia occurred in a hypothermic patient during emergence from general anesthesia

Abstract

A 76-year-old man underwent trans-urethral resection of bladder tumor and laparoscopic total nephroureterectomy of the left renal pelvic and bladder tumor under general anesthesia combined with lumbar epidural anesthesia. Premature ventricular contractions and subsequent ventricular tachycardia occurred at emergence from anesthesia, when his rectal temperature was 33.5°C. Following cardiac massage and lidocaine administration, normal sinus rhythm was obtained. The arrhythmias were suspected to be mainly due to an increase of ventricular alpha- and beta-adrenoreceptor activation induced by perioperative hypothermia and mild hypercapnia.