人工骨頭挿入術中に心室頻拍を発症した慢性腎不全患者の1症例

<p>Patients with Chronic Kidney Disease（CKD）are known to experience various complications including sudden cardiac death. We report the case of 69-year-old male with CKD who developed ventricular tachycardia（VT）during total hip arthroplasty. Induction went smoothly, and the surgery started with the patient in the lateral decubitus position. During surgery, he suddenly developed VT without invitation. Due to the patient's position and the attachments for the posture, it took a while before we placed the defibrillation pads and conducted successful synchronized electrical cardioversion. The patient's potassium level just after the event was 7.9 mEq/L. Calcium gluconate followed by glucose-insulin therapy was initiated and reduced the potassium level at the end of surgery. The patient was extubated after surgery without any neural deficit.</p><p>Since CKD increases the risk of perioperative major adverse cardiac events such as sudden cardiac arrest and fetal arrhythmia, careful preoperative risk assessment and preparation for emergencies are indispensable.</p>