Key result
Total intravenous anaesthesia was safely administered for laparoscopic cholecystectomy and ERCP in a patient with congenital long QT syndrome, resulting in no perioperative arrhythmic events.
Why the study?
Patients with LQTS face risks of life-threatening arrhythmia perioperatively from QT-prolonging volatile anaesthetic agents, prompting interest in total intravenous anaesthesia.
Case Report (n=1)
No
Total intravenous anaesthesia (TIVA) with propofol and opioids, combined with meticulous avoidance of QT-prolonging drugs, can be safely used for general anaesthesia in patients with congenital Long QT Syndrome.
Answers are grounded in this paper and cite their sources.
Supports cautious TIVA use in congenital long QT syndrome; hypothesis-generating pending larger confirmatory studies.
Long QT syndrome (LQTS) is characterised by QT interval prolongation and ventricular arrhythmia, leading to sudden cardiac death. Patients with acquired or congenital LQTS pose special challenges to anaesthetists perioperatively due to the risk of developing life-threatening arrhythmia. A variety of medications, including commonly used volatile anaesthetic agents are known to prolong QT interval and there has been growing evidence of using total intravenous anaesthesia (TIVA) instead of volatile agents for such patients. This is a case report of a 30-year-old patient with congenital LQTS and subcutaneous implantable cardioverter defibrillator (SICD) in situ who underwent laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) under TIVA safely within two months. There were no arrhythmic events observed perioperatively. This case highlights the importance of comprehensive planning and meticulous preparation to avoid all possible QT-prolonging conditions during the perioperative period, especially in patients with acquired or congenital LQTS.
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Zhang et al. (2023) conducted a case report in Congenital Long QT Syndrome (n=1). Total intravenous anaesthesia (TIVA) was evaluated on Perioperative arrhythmic events. Total intravenous anaesthesia was safely administered for laparoscopic cholecystectomy and ERCP in a patient with congenital long QT syndrome, resulting in no perioperative arrhythmic events.
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