Local anesthetics such as bupivacaine have the potential to induce Brugada-type ECG changes and serious arrhythmias in susceptible patients.
May warrant ECG vigilance during bupivacaine epidurals; case report leaves open incidence and management implications.
IMPLICATIONS: In this case report, we describe the postoperative occurrence of electrocardiogram changes suggestive for the Brugada syndrome in a patient receiving a continuous epidural bupivacaine infusion. After withdrawal of bupivacaine, the electrocardiogram changes were reversible. The patient's history was unremarkable except for an incomplete right bundle branch block. We conclude that local anesthetics, particularly bupivacaine, have the potential to induce serious arrhythmias in patients with Brugada syndrome.
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Phillips et al. (2003) studied this question.
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