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2008, Number 4

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Rev Mex Anest 2008; 31 (4)

General anesthesia in patients presenting Brugada’s syndrome

Gómez-Martínez ML, Fernández-Garijo P, Rodríguez-Cabo F, Bustamante-Munguira J, Gómez-Martínez MR, Vegas-Pavesio M, Aldecoa-Santullano C, Gómez-Herreras JI

Language: Spanish
References: 10
Page: 311-314
PDF size: 115.72 Kb.


ABSTRACT

A man with Brugada syndrome underwent an otologic surgery delivery. The operation with general anesthesia was uneventful. Brugada syndrome is characterized by a right bundle branch blockade, ST segment elevation in right precordial leads and a high risk of presenting malignant ventricular arrhythmias (polymorphic ventricular tachycardia and/or ventricular fibrillation) and sudden cardiac death in patients with structurally normal hearts. From 20 to 60 percent of idiopathic ventricular fibrillation could be associated with this syndrome. There are several precipitating factors. General anesthesia in these cases needs continuous ECG recording. The monitoring of the bispectral index, temperature, neuromuscular block and arterial blood pressure is important. In conclusion, we need to know the ECG manifestations of Brugada syndrome, the recommendations for automatic defibrillator implantation (ADI) and the pathophysiological mechanisms to avoid agents or conditions that may induce arrhythmias. During the first 24 hours after the surgery, these patients must be closely monitored by right precordial ECG leads.


REFERENCES

  1. Brugada P, Brugada J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. J Am Coll Cardiol 1992;20:1391-1396.

  2. Brugada J, Brugada R, Brugada P. Right bundle-branch block and ST-segment elevation in leads V1 through V3. A marker for sudden death in patients without demonstrable structural heart disease. Circulation 1998;97:457-460.

  3. Roy D, Waxman HL, Kienzle MG, Buxton AE, Marchlinski FE, Josephson ME. Clinical characteristics and long-term follow-up in 119 survivors of cardiac arrest. Relation to inducibility at electrophysiologic testing. Am J Cardiol 1983;52:969-974.

  4. Antzelevitch C, Brugada P, Borggrefe M, Brugada J, Brugada R, Corrado D, et al. Brugada syndrome: report of the second consensus conference. Heart Rhythm 2005;2:429-40. Review. Erratum in: Heart Rhythm. 2005;2:905.

  5. O´Kelly B, Browner WS, Massie B, Tubau J, Ngo L, Mangano DT. Ventricular arrhythmias in patients undergoing noncardiac surgery. The Study of Perioperative Ischemia Research Group. JAMA 1992;268:217-221.

  6. Kasanuki H, Ohnishi S, Ohtuka M, Matsuda N, Nirei T, Isogai R, et al. Idiopathic ventricular fibrillation induced with vagal activity in patients without obvious heart disease. Circulation 1997;95:2277-2285.

  7. Antzelevitch C, Brugada R. Fever and Brugada syndrome. Pacing Clin Electrophysiol 2002;25:1537-1539.

  8. Kim JS, Park SY, Min SK, Kim JH, Lee SY, Moon BK, et al. Anaesthesia in patients with Brugada syndrome. Acta Anaesthesiol Scand 2004;48:1058-1061.

  9. Santambrogio LG, Mencherini S, Fuardo M, Caramella F, Braschi A. The surgical patient with Brugada syndrome: a four-case clinical experience. Anesth Analg 2005;100:1263-1266.

  10. Niyazi G, Ismail K, Cengiz BD, Mehmet B, Beyhan E, Cevat T. The effects of volatile anesthetics on The Q-Tc interval. J Cardio Vasc Anesth 2001;15:188-191.




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