Anesthetic management for inhibiting sympathetic activation in an adolescent patient diagnosed with catecholaminergic polymorphic ventricular tachycardia and undergoing left cardiac sympathetic denervation: A case report

Abstract

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a genetic disorder in which catecholamine release during exercise or emotional stress cause fatal tachyarrhythmias. In this paper, we discuss methods to minimize the sympathetic stimulation that can occur during the perioperative period in patients undergoing left cardiac sympathetic denervation to surgically treat CPVT.

Smooth Emergence from General Anesthesia after Deep Extubation in a Pediatric Patient Diagnosed with Catecholaminergic Polymorphic Ventricular Tachycardia: A Case Report

“…Despite these advantages, deep extubation with pharmacologic intervention should not be routinely applied to extubation in CPVT patients. The administration of dexmedetomidine may exacerbate preexisting bradycardia and hypotension in patients with beta-blocker therapy [16]. Furthermore, deep extubation can increase the risk of airway obstruction, which poses a threat to patient safety [15].…”

“…There are no specific contraindications to the use of local anesthetics in CPVT patients. In other studies, ropivacaine was safely used in serratus plane blocks for CPVT patients [16], and bupivacaine was safely used in combined spinal-epidural anesthesia [21]. However, it is contraindicated to mix local anesthetics with epinephrine [4].…”