Key result
A combination of propofol, rocuronium, and sugammadex was effectively and safely used for a patient with a Brugada ECG pattern undergoing numerous cycles of electroconvulsive therapy.
Case Report (n=1)
No
The combination of propofol, rocuronium, and sugammadex provides safe and effective anesthetic management for electroconvulsive therapy in patients with a Brugada ECG pattern, avoiding drugs that may trigger malignant arrhythmias.
May guide anesthetic selection in Brugada-ECT; hypothesis-generating and requires prospective validation before broader use.
Brugada syndrome is characterized by an electrocardiograph pattern of right bundle-branch block and has an increased risk for cardiac arrest due to malignant arrhythmia. We describe the successful anesthetic management for electroconvulsive therapy in a patient with Brugada electrocardiograph pattern. Patients with Brugada ECG pattern are not recommended to use neostigmine which augments ST elevation. Sugammadex was administered as a neuromuscular reversal agent in this case. Sugammadex provides rapid reversal of profound rocuronium-induced neuromuscular blockade under propofol anesthesia.
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Tsutsumi et al. (2011) conducted a case report in Brugada ECG pattern and severe major depression (n=1). Propofol, rocuronium, and sugammadex was evaluated on Hemodynamic stability and safe completion of electroconvulsive therapy. A combination of propofol, rocuronium, and sugammadex was effectively and safely used for a patient with a Brugada ECG pattern undergoing numerous cycles of electroconvulsive therapy.
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