INTRAOPERATIVE VENTRICULAR BIGEMINY: REPORT OF 5 CASES

Five patients who had intraoperative ventricular bigeminy while undergoing various orthopaedic procedures are reported. Diagnosis of pulsus bigeminus was established by continuous intraoperative ECG monitoring of lead 11 using a Micromon 7142 (L T Medical) ECG machine. Causes of these arrhythmias were traced to hypokalaemia, inadequate analgesia, old age, previous rheumatic heart disease and sensitization of the myocardium to catecholamines by halothane. All patients were successfully managed either with intravenous potassium administration, additional analgesia or intravenous lignocaine. The importance of preoperative patient investigations and intraoperative monitoring is highlighted.