Anaesthetic management of a case of atrial fibrillation posted for transurethral laser resection of  prostate.

Dr. Jateen Amonkar; Dr. (col) V.R.R Chari; Dr. Pranita Kate; Dr. Soumyanath Maiti; Dr. Farha Nasreen; Dr. Arnab Paul

Volume : VII, Issue : I, January - 2017

Anaesthetic management of a case of atrial fibrillation posted for transurethral laser resection of prostate.

Dr. Jateen Amonkar, Dr. Col V. R. R Chari, Dr. Pranita Kate, Dr. Soumyanath Maiti, Dr. Farha Nasreen, Dr. Arnab Paul

Abstract :

Atrial fiillation is one of the most common arrhythmias occurring in 0.4–0.5% of adult population. It may be encountered pre operatively in patients posted for anesthesia and may occur during anesthesia or may occur or persist in postoperative period. A rapid heart rate with loss of atrial systolic function and irregular ventricular response associated with impaired ventricular diastolic function may result into hemodynamic deterioration and reduced cardiac output. Surgical patients may present with atrial fiillation due to pre–existing AF, new onset AF or paroxysmal AF. The acute onset AF is usually treated by direct current cardioversion when patient is unstable but pharmacological agents like amiodarone, diltiazem, digoxin can also be used to achieve pharmacological cardioversion. In this case patient had was a diagnosed case of atrial fiillation and was digitalized.He had a 65gm prostate gland which was resected with the help of a laser.Anaesthesia planned was single shot sacral epidural keeping hemodynamic goals in consideration.Intraoperatively patient developed a episode of atrial fiillation which was treated with Inj amiodarone 150 mg slowly over 10 mins thereafter controlling the hreat rate.

The aim of this particular case report is to review the management strategies of atrial fiillation with particular attention given on the management of perioperative atrial fiillation and prevent further complications. Here we report a successful management of a 70–year–old diabetic male with atrial fiillation since 6 months posted for Trans Urethral laser Resection of Prostrate.