Pt in her early 20s had a history of "fast heart rates", not formally diagnosed by a physician. Becomes mildly symptomatic when it occurs at home... sits down until it goes away.
During c-section with SAB becomes tachycardic with HRs in the 180s. BP stable in the 110s to 120s, but pt states she is becoming dizzy and short of breath.
In my anesthesia drawer I have Esmolol, Metoprolol, and Verapamil. I also have Edrophomium and Neostigmine for those who favor a less traditional (or perhaps more traditional) approach.
Which of the afore mentioned medications would be my best bet for treating the patients tachycardia assuming vagal maneuvers had failed and why?
