The Romano-Ward syndrome is a congenital form of long Q-T syndrome which frequently causes syncope, dysrhythmias and sudden death. Certain anaesthetic drugs can precipitate dangerous dysrhythmias. Chronic P-adrenergic blockade is the therapy of choice for symptomatic patients and establishment of complete and total P-blockade is recommended for symptomatic patients having anaesthesia and surgery. We report the successful use of esmolol to establish rapid and total P-blockade before a short elective out-patient procedure and suggest that esmolol may be useful for other patients with Romano-Ward syndrome having anaesthesia and surgery.
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