Esmolol in the anaesthetic management of a boy with Romano–Ward syndrome

The Romano–Ward syndrome is a congenital form of long Q‐T syndrome which frequently causes syncope, dysrhythmias and sudden death. Certain anaesthetic drugs can precipitate dangerous dysrhythmias. Chronic β‐adrenergic blockade is the therapy of choice for symptomatic patients and establishment of complete and total β‐blockade is recommended for symptomatic patients having anaesthesia and surgery. We report the successful use of esmolol to establish rapid and total β‐blockade before a short elective out‐patient procedure and suggest that esmolol may be useful for other patients with Romano–Ward syndrome having anaesthesia and surgery.