室安卡因注射液致心跳骤停一例山西医学院第一附属医院（０３０００１）李德宏，阎晓梅，王陆建患者：女，４８岁。主因间断性眼黑、心悸、昏厥３年，以病态窦房结综合征收入院。查体：体温３７℃，呼吸２０次／分，脉搏６８次／分，血压１４．７／９．０６ｋＰａ，一般情况尚可，神清。双肺未闻及异常，心率６８次／分、律齐，各瓣膜未闻及杂音。腹软，肝脾未触及，双下肢无浮肿，生理反射存在，病理反射未引出。血、尿常规、肝功能、血脂、血糖均正常。２４小时动态心电图可见心律不齐，最慢心率３６次／分，最快心率１０８次／分，最长间歇２秒。电生理检查—食管调搏，最长ＳＮＲＴ２．８秒。然后静注室安卡因６００ｍｇ，１０分钟推完，重复食道调搏，可见５．８秒的ＳＮＲＴ，仍无自主心律，快速食道起搏，病人恢复自主心律。重复多次，可见４．５秒、６秒的ＳＮＲＴ，均靠食道起搏恢复自主心律，病人置入人工心脏起搏器后出院。讨论：文献报道室安卡因对有病变的窦房结可延长窦房结恢复时间，我们共对８例病态窦房结的病人静注室安卡因６００ｍｇ做电生理检查，亦发现４例窦房结恢复时间（ＳＮＲＴ）延长，此例为观察到的最典型的一例，故窦房结有病变的病人，使用室安卡因注射液时应慎重。室安 Room Ancaine injection caused a cardiac arrest, the First Affiliated Hospital of Shanxi Medical University (030001) Li Dehong, Yan Xiaomei, Wang Lu Jian patients: female, 48 years old. Main due to intermittent black eye, palpitations, fainting 3 years to sick sinus syndrome syndrome admission hospital. Physical examination: body temperature 37 ℃, breathing 20 beats / min, pulse 68 beats / min, blood pressure 14.7 / 9.06kPa, the general situation is acceptable, Shen Qing. Unobserved lungs and abnormalities, heart rate 68 beats / min, law Qi, the valve did not smell and noise. Abdominal soft, liver and spleen not touched, no swelling of both lower extremities, the presence of physiological reflex, the pathological reflex did not lead. Blood, urine, liver function, blood lipids, blood glucose were normal. 24-hour ambulatory ECG shows arrhythmia, the slowest heart rate 36 beats / min, the fastest heart rate 108 beats / min, the longest intermittent 2 seconds. Electrophysiology - esophageal pacing, the longest SNRT2.8 seconds. Then intravenous analgesic Ankaine 600mg, 10 minutes pushed finished, repeat esophageal pacing, showing 5.8 seconds SNRT, there is no autonomic rhythm, rapid esophageal pacing, the patient regained independent rhythm. Repeated many times, we can see 4.5 seconds, 6 seconds SNRT, are dependent on esophageal pacing to restore autonomic heart rhythm, the patient was placed in artificial cardiac pacemaker after discharge. Discussion: Reported in the literature of room sinus aneurysm with lesions can extend the recovery time of sinus node, we a total of 8 cases of sick sinus node patient intravenous anchain 600mg electrophysiological examination, also found in 4 cases Sinus node recovery time (SNRT) prolongation, this case is the most typical case observed, so patients with lesions in the sinus node, the use of intraventricular injection should be careful. Room security