Today morning I was called upon to give anaesthesia for lscs. Patient was 26 yr old primi with no comorbidities. It was an elective caesarean. Preanaesthetic checkup was done. Everything was normal.Her prep op vitals were all in the normal range. Her preop ECG was normal.Spinal anaesthesia was given and pt was placed in a supine position. Before giving the incision pt had an increased HR with monitor showing AF. Rate was around 185-205 per min. 100%O2 was given.
Inj metoprolol 5 mg in incremental doses was given. Rate decreased to around 150. Caesarean was started. Baby was alright. Further inj diltiazem 15mg in total was given . Rate further decreased to around 90_110. Throughout patient remained hemodynamically stable. Surgery was completed but pt had irregularly irregular HR throughout. In the meantime physician was called who prescribed tab diltiazem 30mg tid plus inj enoxaparin…
