Anesthetic and Perioperative Management of Patients With Brugada Syndrome

Dendramis, Gregory; Paleologo, Claudia; Sgarito, Giuseppe; Giordano, Umberto; Verlato, Roberto; Baranchuk, Adrián; Brugada, Pedro

doi:10.1016/j.amjcard.2017.06.034

Cited by 23 publications

(37 citation statements)

References 27 publications

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“…A lot of case reports have been described the anesthetic management of patients with Brugada syndrome but safe anesthesia in these patients remains controversial [2,4,6]. In additions, there is no consensus which is the best between local or general anesthesia [2,4,6].…”

Section: Discussionmentioning

confidence: 99%

“…In additions, there is no consensus which is the best between local or general anesthesia [2,4,6]. Propofol have been associated with the development of arrhythmias in patients with Brugada syndrome however events have mainly described during prolonged infusion [2,6]. Limited dose and duration of Propofol use for maintenance anesthesia and is probably safe [2,6].…”

Section: Discussionmentioning

confidence: 99%

“…Pathophysiology included a sodium channelopathies which result in a reduction of sodium inflow current, thereby reducing phase 0 depolarization of the action potential and repolarization heterogeneity [1,4]. The association with ventricular arrhythmias and cardiac dysfunction is of concern to the anesthetist because medications routinely used in anesthetic practice may precipitate these events [2,5,6]. A Web site (www.brugadadrugs.org) was developed to ensure up-to-date availability of relevant information.…”

Section: Discussionmentioning

confidence: 99%

“…We could not obtain more information about these anesthesias. Past medical history our knowledge, there is not report use in Brugada syndrome patients [2,6]. Regarding halogenated anesthetics, sevoflurane might be best since it has no effect on QT length [2,6].…”

Section: Case Reportmentioning

confidence: 99%

“…Local anesthetics like bupivacaine, ropivacaine and levobupivacaine have been associated with ECG changes and ventricular tachycardia while some evidence suggests that lidocaine when combined with adrenaline/ epinephrine may be used safely in Brugada syndrome [2,6,7].…”

Section: Case Reportmentioning

confidence: 99%

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Hypnosis and Transversus Abdominis Plane Block for Brugada Syndrome Anesthesia: A Case Report

Santos¹,

Cailleau²,

Coscoy³

et al. 2017

Clin Med Rev Case Rep

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SummaryBrugada syndrome is a distinct form of an arrhythmic disease affecting ionic channels of the heart. We report the anesthetic management of a patient with Brugada syndrome for inguinal hernia repair which was managed satisfactorily with combined light anesthesia, hypnosis with indirect suggestions and transversus abdominis plane block. KeywordsAnesthesia, Brugada syndrome, Hypnosis, Transversus abdominis plane block found a Brugada syndrome but there was no history of angina, syncope and the effort tolerance was about eight Metabolic Equivalents (METS). Family history was negative for Brugada syndrome and for sudden cardiac death. The patient had no history of abnormal clinical bleeding and was not taking any medications. His ASA physical status classification was 2.Brugada syndrome was diagnostic in 2014 because of a chest pain during night. His investigations were within normal limit except surface electrocardiogram that found ST segments < 1 mm with saddle-type pattern (Brugada type 2). A provocative drug test with intravenous administration of ajmaline induced type 1 ECG morphology with ST-segment elevation > 2 mm).Because he has a Brugada syndrome type 2 with no history of ventricular fibrillation or syncope and no family history of sudden cardiac death, cardioverter defibrillator was not implanted [1][2][3].Monitoring consisted of ECG with continuous ST segment analysis, a pulse oximeter and non-invasive blood pressure measurement. He was connected to Oxygen 2 L/min with nasal cannula and an external defibrillator pads with an external defibrillator was placed. Venous puncture (18G) was performed. After premedication with midazolam (1 mg), a TAP block was performed with 1% lidocaine adrenaline with ultrasound guidance and a total dose of 200 mg was injected. In addition to that, anesthetists nurse started hypnosis giving permissive and indirect suggestions of well-being. Even though

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