IDIOSYNCRATIC SUPRAVENTRICULAR TACHYCARDIA AFTER EPIDURAL ANESTHESIA

Authors

  • B. J. Stickles CNM, MSN

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    • B. J. Stickles, CNM, MSN, received a B.S.N. from the University of Wisconsin and an M.S.N. and C.N.M. from Columbia University. She has been a clinical instructor, teaching faculty, and director of nurse-midwifery services in university and university-affiliated medical centers. She is a patent holder for a teaching model, a pilot, and a decorated Viet Nam War veteran.


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ABSTRACT

During pregnancy, stress and vigorous exercise often result in pronounced tachycardia. Generally, a vagal stimulatory effort will interrupt the episode; however, intrapartum supraventricular tachycardia may not respond to vagal stimulation, necessitating drug therapy.

This article is a case report of idiosyncratic supraventricular tachycardia following initiation of epidural analgesia; use of epinephrine was part of the test dose protocol. Adenosine, chosen for the lack of hypotensive effect associated with verapamil, was administered intravenously with immediate results. Fetal monitoring via scalp electrode provided evidence of fetal well-being during and after the episode.

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