BACKGROUND: Practice standards recommend that the induction of epidural analgesia for labor begin with a test dose of local anesthetic with epinephrine. During the test dose period and following anesthetic administration, the anesthesiologist measures the parturient's pulse with continuous pulse oximetry to help detect the intravascular placement of the epidural catheter as evidenced by the abrupt onset of tachycardia. CASE REPORT: We report the onset of tachycardia in a healthy parturient following induction of continuous epidural analgesia. The tachycardia was ultimately diagnosed as lone atrial fibrillation-a finding not previously reported in the literature. CONCLUSION: We initially thought the diagnosis portended undetected cardiac disease, but further assessment found no cardiac abnormalities.
BACKGROUND: Practice standards recommend that the induction of epidural analgesia for labor begin with a test dose of local anesthetic with epinephrine. During the test dose period and following anesthetic administration, the anesthesiologist measures the parturient's pulse with continuous pulse oximetry to help detect the intravascular placement of the epidural catheter as evidenced by the abrupt onset of tachycardia. CASE REPORT: We report the onset of tachycardia in a healthy parturient following induction of continuous epidural analgesia. The tachycardia was ultimately diagnosed as lone atrial fibrillation-a finding not previously reported in the literature. CONCLUSION: We initially thought the diagnosis portended undetected cardiac disease, but further assessment found no cardiac abnormalities.
Authors: Valentin Fuster; Lars E Rydén; David S Cannom; Harry J Crijns; Anne B Curtis; Kenneth A Ellenbogen; Jonathan L Halperin; Jean-Yves Le Heuzey; G Neal Kay; James E Lowe; S Bertil Olsson; Eric N Prystowsky; Juan Luis Tamargo; Samuel Wann; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Jeffery L Anderson; Elliott M Antman; Sharon Ann Hunt; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel; Silvia G Priori; Jean-Jacques Blanc; Andrzej Budaj; A John Camm; Veronica Dean; Jaap W Deckers; Catherine Despres; Kenneth Dickstein; John Lekakis; Keith McGregor; Marco Metra; Joao Morais; Ady Osterspey; José Luis Zamorano Journal: J Am Coll Cardiol Date: 2006-08-15 Impact factor: 24.094