PATIENT WITH IMPLANTED PACEMAKER: GENERAL AND ANAESTHETIC CONSIDERATIONS

Dr. Jatin Lal; Dr. Manu Smriti; Dr. Teena Bansal

Volume : V, Issue : XI, November - 2015

PATIENT WITH IMPLANTED PACEMAKER: GENERAL AND ANAESTHETIC CONSIDERATIONS

Dr. Jatin Lal, Dr. Manu Smriti, Dr. Teena Bansal

Abstract :

The use of implantable pacemakers to treat heart problems is growing and as a result more patients with these devices are presenting for elective or emergency surgery. The complexity of these devices continues to increase with explosion in current technology and it is incumbent on anaesthesiologists to be familiar with current recommendations and essential tenets of these devices in the interest of patient safety. These patients should be managed with multidisciplinary individualized approach based on focused history, physical examination, interrogation of pacemaker before and after the procedure and reprogramming it, if required. Careful perioperative monitoring of ECG, pulse oximetry, arterial blood pressure, electrolyte and metabolic disturbances should be done. Emergency drugs, temporary pacing and defiillation should be kept ready. Drugs and equipments interfering with pacemaker function should be avoided. Post procedure, continuous monitoring of cardiac rate and rhythm should be done along with consultation of a cardiologist.