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

Figures

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  FIGURE 1. The defibrillator strips show resuscitation from ventricular fibrillation when shocked with 200 J.

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  FIGURE 2. Setting the defibrillator for unexpected intraoperative ventricular fibrillation with the front pad placed on the upper right torso above the right nipple just below the clavicle (small circle) and the lateral pad placed on the side of the chest below the left breast to avoid interfering with the surgical site (large circle). Note that the lateral pad should originally be placed in the 5th or 6th intercostal space on the left anterior axillary line. After discussion with the surgeon, it was decided that the lateral pad should be placed in this location to avoid the surgical site and ensure a sufficient sterile area.

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  FIGURE 3. Ultrasound images of the serratus plane block. Local anesthesia is injected into the deep plane (A) and superficial plane (B) through a Tuohy needle (arrows). LA, local anesthetics, LDM, latissimus dorsi muscle, SAM, serratus anterior muscle.

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  FIGURE 4. The follow‐up electrocardiogram, obtained 3 months after surgery, shows a sinus rhythm and a heart rate of 61 beats/min.