Epidural analgesia in a parturient with Brugada syndrome

Sleipness, Evan P.; Gonzalez, Sara C.

doi:10.1016/j.jclinane.2020.109944

Cited by 1 publication

(1 citation statement)

References 5 publications

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“…Indeed, while bupivacaine has been used intrathecally [18,19], it has been implicated in the induction of a Brugada-type ECG pattern when administered via epidural catheter [20]. Ropivacaine has been used as an epidural infusion in patients with Brugada syndrome [21,22], although one patient developed ventricular tachycardia after bilateral paravertebral blockade with Ropivacaine [23].…”

Section: Discussionmentioning

confidence: 99%

Labor Analgesia in Brugada Syndrome and the Importance of Contingency Planning

Mena

Costa

DeLemos

et al. 2022

Case Reports in Anesthesiology

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Brugada syndrome is an autosomal dominant disorder that affects cardiac sodium channels and predisposes patients to an increased risk of sudden cardiac death. Obstetric anesthesia management in patients with Brugada syndrome poses a challenge due to the prevalence of local anesthetic use for labor analgesia or cesarean section. However, central neuraxial techniques and local anesthetics have been used safely in parturients with this syndrome and may be offered to patients during preadmission counseling. We present the case of a primigravida who opted for further labor analgesia via a combined spinal-epidural technique. To our knowledge, this is the first case report of a lidocaine infusion administered via an epidural catheter to a laboring parturient with Brugada syndrome. We further discuss the use of local anesthetics, other medications, and central neuraxial techniques in those with Brugada syndrome to assist anesthesiologists caring for expectant mothers.

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