TREATMENT OF MILRINONE-ASSOCIATED TACHYCARDIA WITH BETA-BLOCKERS

Purpose: To describe a case of milrinone-associated tachycardia that w as successfully treated with two beta-blockers. Clinical features: A 7 4-yr-old male patient underwent elective abdominal aortic aneurysm rep air under combined epidural/general anaesthesia. He had a history of a lcohol abuse, controlled hypertension and ischaemic heart disease. Pos toperatively, the patient had persistent sinus tachycardia that was in itially unsuccessfully treated with metoprolol. Subsequently, the pati ent's blood pressure and cardiac index decreased with an associated in crease in pulmonary/artery pressure. Analysis of the ST-segment reveal ed no evidence of myocardial ischaemia or infarction, These haemodynam ic changes were treated with milrinone which exacerbated the baseline tachycardia without adverse blood pressure response. The subsequent ad ministration of beta-blockers (esmolol and metoprolol) was successful in controlling the heart rate response to milrinone without adversely affecting the patient's haemodynamic profile, Conclusion: This report demonstrates the efficacy of esmolol and metoprolol for the treatment of milrinone-associated tachycardia, without compromising the haemodyn amic effects of milrinone.