Mobitz Type II Atrioventricular Block Followed by Remifentanil in a Patient with Severe Aortic Stenosis

Opioids have been considered for their hemodynamic stability. Remifentanil is an opioid analgesic with rapid metabolism and fast primary effect and recovery. In this paper, a very rare effect of using remifentanil along with propofol was presented. An 84-year-old male patient with severe aortic sten...

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Main Authors: Mehryar Taghavi Gilani, Majid Razavi
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Anesthesiology
Online Access:http://dx.doi.org/10.1155/2013/852143
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author Mehryar Taghavi Gilani
Majid Razavi
author_facet Mehryar Taghavi Gilani
Majid Razavi
author_sort Mehryar Taghavi Gilani
collection DOAJ
description Opioids have been considered for their hemodynamic stability. Remifentanil is an opioid analgesic with rapid metabolism and fast primary effect and recovery. In this paper, a very rare effect of using remifentanil along with propofol was presented. An 84-year-old male patient with severe aortic stenosis underwent general anesthesia. In order to induce anesthesia and maintain it, fentanyl, pancuronium, and propofol, along with a combination of propofol and remifentanil, were used, respectively. At beginning of remifentanil infusion, bradycardia and then Mobitz type II conduction block with a hemodynamic disorder occurred for the patient. The decreased blood pressure responded to injection of atropine and ephedrine; however, dysrhythmia only improved after cessation of remifentanil. Therefore remifentanil should be used with caution in aortic stenosis.
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spelling doaj-art-6686cae5263f440cb446900da04c445d2025-08-20T02:23:45ZengWileyCase Reports in Anesthesiology2090-63822090-63902013-01-01201310.1155/2013/852143852143Mobitz Type II Atrioventricular Block Followed by Remifentanil in a Patient with Severe Aortic StenosisMehryar Taghavi Gilani0Majid Razavi1Anesthesia Department, Imam-Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAnesthesia Department, Imam-Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranOpioids have been considered for their hemodynamic stability. Remifentanil is an opioid analgesic with rapid metabolism and fast primary effect and recovery. In this paper, a very rare effect of using remifentanil along with propofol was presented. An 84-year-old male patient with severe aortic stenosis underwent general anesthesia. In order to induce anesthesia and maintain it, fentanyl, pancuronium, and propofol, along with a combination of propofol and remifentanil, were used, respectively. At beginning of remifentanil infusion, bradycardia and then Mobitz type II conduction block with a hemodynamic disorder occurred for the patient. The decreased blood pressure responded to injection of atropine and ephedrine; however, dysrhythmia only improved after cessation of remifentanil. Therefore remifentanil should be used with caution in aortic stenosis.http://dx.doi.org/10.1155/2013/852143
spellingShingle Mehryar Taghavi Gilani
Majid Razavi
Mobitz Type II Atrioventricular Block Followed by Remifentanil in a Patient with Severe Aortic Stenosis
Case Reports in Anesthesiology
title Mobitz Type II Atrioventricular Block Followed by Remifentanil in a Patient with Severe Aortic Stenosis
title_full Mobitz Type II Atrioventricular Block Followed by Remifentanil in a Patient with Severe Aortic Stenosis
title_fullStr Mobitz Type II Atrioventricular Block Followed by Remifentanil in a Patient with Severe Aortic Stenosis
title_full_unstemmed Mobitz Type II Atrioventricular Block Followed by Remifentanil in a Patient with Severe Aortic Stenosis
title_short Mobitz Type II Atrioventricular Block Followed by Remifentanil in a Patient with Severe Aortic Stenosis
title_sort mobitz type ii atrioventricular block followed by remifentanil in a patient with severe aortic stenosis
url http://dx.doi.org/10.1155/2013/852143
work_keys_str_mv AT mehryartaghavigilani mobitztypeiiatrioventricularblockfollowedbyremifentanilinapatientwithsevereaorticstenosis
AT majidrazavi mobitztypeiiatrioventricularblockfollowedbyremifentanilinapatientwithsevereaorticstenosis