Post induction arrhythmia in a renal patient: an unexpected risk factor

摘要: Summary A 44 year-old woman was anaesthetised for a transplant nephrectomy. About 10 min after induction of anaesthesia she had several runs ventricular tachycardia followed by fibrillation requiring 30 s cardiopulmonary resuscitation, which reverted to sinus rhythm. Review her chest X-ray, suggested that the haemodialysis catheter (Permcath™) position may have precipitated this event. However, subsequent investigation found toxic serum levels sotalol, with prolonged corrected QT interval on electrocardiogram. She started sotalol while renal graft functioning well but it not reviewed when fail and commence haemodialysis. This led accumulation explains value 7.1 mg.l−1 day Concentrations greater than 2.5 mg.l−1 are generally considered toxic.