Brugada Syndrome Induced by an Interscalene Block

Corey, Sally A.; Varkey, Santosh; Phillips, D. Z.

doi:10.2106/jbjs.cc.17.00030

Cited by 8 publications

(2 citation statements)

References 17 publications

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“…Furthermore, it is known to act on EP1 subtype of prostaglandin E2 and reducing inflammation and hyperalgesia (74).It has been listed as a class IIa drug for patients with brugada with the studies having shown it to be pro arrhythmic for such patients (12). In our review we observed patients previously having masked brugada pattern showing a classical brugada pattern on ECG without any symptom after administration (21,45), however there were studies showing ventricular fibrillation (29) and cardiac arrest (40) in patients thus highlighting its potential risk.…”

Section: Bupivacainementioning

confidence: 85%

Brugada Syndrome and Anesthesia: A Systematic Review

Suchal

Afzal

Karim

2022

Preprint

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Brugada Syndrome is an inherited disorder causing specific changes on electrocardiogram (ECG) pattern of right bundle branch block and persistent ST elevation in right precordial leads increases the risk of cardiac arrest and fatal arrhythmia. Patients with brugada are prone to abnormal cardiac rhythms which can be induced by alcohol, stress, vagal stimulation, and certain medications. Thus medications are divided into different classes from I to III with I carrying the most evidence for potential arrhythmia while III being the least likely. Exceptional care needs to be taken to avoid anesthetic and analgesic during surgeries for such patients as several of the known anesthesia medications can lead to arrhythmia in these patients. In this review we aimed to study the effect different anesthetic and analgesic medication could have on patients with brugada syndrome. We conducted a systematic review following PRISMA guidelines to query PubMed, Embase, Cochrane library and ProQuest electronic databases. Mesh combinations and synonyms of “Brugada Syndrome”, “Anesthesia”, “Analgesics” were used. We included all original human studies that focused on outcomes of anesthetic and analgesics on patients with brugada. After screening 1149 studies, we included 49 articles consisting of a total of 1414 subjects for qualitative analysis. We found local analgesics to be least likely to lead to potential arrhythmic complications with other systemic and inhaled agents having a risk although the risk varied because of multitude of reasons ranging from type of drug to patient factors like the patient’s condition and type of Brugada. We concluded that anesthetic although could be used for individuals with Brugada the type of anesthetic to be used should be selected keeping the potential cardiac risk under consideration.

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Section: Bupivacainementioning

confidence: 85%

Brugada Syndrome and Anesthesia: A Systematic Review

Suchal

Afzal

Karim

2022

Preprint

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“…23 , 24 However, an interscalene block using 30 mL of 0.5 % bupivacaine did result in a ventricular fibrillation arrest. 25 An axillary block has been successfully preformed using ropivacaine and coinciding empiric intralipid treatment. 26 An ilioinguinal block, sub-tenon’s block, peribulbar block, and intraoral injection for tooth extraction have all been unremarkable with no arrhythmias or EKG changes.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Lower Extremity Peripheral Nerve Blocks for Post-operative Pain Control in a Multi-trauma Patient with Brugada Syndrome: A Literature Review and Case Report

Bergbower,

Lorico,

Kaur

et al. 2024

Journal of Community Hospital Internal Medicine Perspectives

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We describe the case of a 28-year-old man with Brugada syndrome who received single-shot adductor canal and sciatic nerve blocks for the management of post-operative pain related to extensive orthopedic injuries. Low-dose ropivacaine with glucocorticoid additives was administered without any EKG changes, arrhythmias, or syncopal sensations. The patient experienced pain relief for over 24 h and was monitored on telemetry with defibrillator pads as a cardiac precaution. This case adds a valuable data point in the limited canon of information on the safety and efficacy of regional anesthesia in Brugada syndrome for the perioperative physician.

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Bupivacaine

2018

Reactions Weekly

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Brugada Syndrome Induced by an Interscalene Block

Abstract: Brugada syndrome is an abnormality of the cardiac conduction system that leads to cardiac arrhythmias. Several anesthetic agents trigger Brugada-like electrocardiographic abnormalities. To our knowledge, this is the first report of an interscalene block inducing Brugada syndrome.

Cited by 8 publications

References 17 publications

Brugada Syndrome and Anesthesia: A Systematic Review

Brugada Syndrome and Anesthesia: A Systematic Review

Lower Extremity Peripheral Nerve Blocks for Post-operative Pain Control in a Multi-trauma Patient with Brugada Syndrome: A Literature Review and Case Report

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