一位嚴重低血鉀之病患因疼痛而引發無脈性心室頻脈之病例報告

Pulseless Ventricular Tachycardia by Pain in a Patient with Severe Hypokalemia-A Case Report

嚴重低血壓會引發足以危害生命的心律不整，巳有眾多文獻足資證明。在嚴重低血僻的情形下，若再加上本來就足以引起神經內分泌壓力反應與心律不整的疼痛，可能會造成更嚴重的心律不整，其影響不容忽視。我們要報告一位嚴重低血御病患於無麻醉情形之下更換紗布時，因為疼痛引起原本間歇性的心室心律不整進展為足以危害生命的無脈性心室頻脈。由本病例可知有效的疼痛控制對危急的病患極為重要。

The role of severe hypokalemia in triggering life-threatening ventricular arrhythmia is well documented. When severe hypokalemia is coupled with pain, which can not only induce neuroendocrine stress response but also cause arrhythmias, the impact should not be overlooked because aggravated arrhythmia may ensue. Here we report a case of a life-threatening ventricular tachycardia which was triggered from intermittent ventricular arrhythmia by pain during change of dressings on an unanesthetized patient with severe hypokalemia. This case illustrates the importance of effective pain management in critical patients.