A 28-year-old woman developed drug-induced tachycardia in the left lateral decubitus (LLD) position following intravenous administration of glycopyrrolate. The tachycardia was unresponsive to esmolol, labetalol, and fentanyl but resolved unexpectedly after the tidal volume was reduced from 8 to 6 mL/kg. Drug-induced tachycardia or arrhythmia occurring in the LLD position under mechanical ventilation may be attenuated by adopting a low tidal volume ventilation strategy (6 mL/kg).
Keywords: Anesthesia; Autonomic nervous system; Case reports; Cholinergic antagonists; Heart rate; Posture; Ventilation.