Brugada Syndrome and Anesthetic Management

Brugada syndrome and anesthesia

“…Our research also indicated that the inhalation anesthetics isoflurane, [27,45,46] desflurane, [27,34] sevoflur ane, [27][28][29][31][32][33]35,41,43,[47][48][49] and N 2 O [27,29,31,43,45,48] were safely Horigome et al [42] 13/M Fuyuta et al [32] 72/M Phillips et al [33] 77/M [34] anterior chest wall wound induction (propofol 140 mg, vecuronium 8 mg), maintenance (desflurane, vecuronium 20 mg, fentanyl)…”

“…However, concerns about neostigmine have led some authors to prefer sugammadex, which was used safely in two of the reported cases. [30,36] Additionally, we found that atropine was selected for use in only one case [54] and that glycopyrrolate [27,31,45,48] was more commonly applied as an anticholinergic agent.…”

“…[42] The opioids fentanyl, [28,[31][32][33][34][35]37,38,[41][42][43][45][46][47][48]50] sufentanil, [40] morphine, [42] and remifentanil [28,32] were frequently prescribed as adjuvants to general anesthesia. Two patients were also given opioids via an epidural.…”

“…Our patients also received the NMBAs vecuronium, [27,29,34,35,43,45,46,54] rocuronium, [30][31][32][33]36] cisatracurium, [28,47] succinylcholine, [27,38,45] and atracurium [37,38,48] but succinylcholine is not normally used because of its adverse effects. [29] As an anticholinesterase agent, neostigmine is also avoided because it can lead to ST-segment elevation in BS patients.…”

Anesthetic management of a patient with Brugada syndrome

“…Sudden polymorphic ventricular tachycardia developed 20 min after dopamine. Cordery et al (14), also used propofol for induction. After the procedure they gave neostigmine and glycopryrrolate for reversal of muscle relaxation.…”