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November 1, 2022Advances in life science and technologyOpen Access

Patient with Wolff-Parkinson-White Syndrome undergoing Non-Cardiac Surgery. Perioperative Management

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Key result

Avoiding neuromuscular blockers and sympathetic stimulation allows arrhythmia-free surgery in a WPW syndrome case.

  • n=1

Why the study?

Pre-excitation syndromes have mainly been approached from a disease perspective, leaving anesthetic and perioperative management data scarce.

Population

A patient with Wolff-Parkinson-White syndrome undergoing non-cardiac surgery

Design

Case report

Authors

MZMerita ZekaHygeia HospitalMGMarsela GogaMother Teresa HospitalSKSaimir KuçiMother Teresa Hospital

Discussion

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Implication

May support avoiding neuromuscular blockers in WPW surgery; hypothesis-generating for arrhythmia prevention.

Key Points

  • To examine optimal perioperative anesthetic strategies for preventing life-threatening arrhythmias in patients with Wolff-Parkinson-White syndrome undergoing non-cardiac surgery.
  • Reviewed the perioperative and anesthetic management of a patient presenting with preexcitation syndrome during non-cardiac surgery.
  • Omitting neuromuscular blockers during general anesthesia with a laryngeal mask airway helped avoid intraoperative cardiac arrhythmias.
  • Minimizing sympathetic stimulation prevented shortening of the accessory pathway's refractory period, mitigating the risk of fatal arrhythmias.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
A 38-year-old woman with Wolff-Parkinson-White syndrome and hyperthyroidism who underwent plastic breast surgery under general anesthesia.
I
Intervention
Perioperative management avoiding neuromuscular blockers and sympathetic stimulation
O
Outcome
Prevention of life-threatening arrhythmias

In patients with Wolff-Parkinson-White syndrome undergoing non-cardiac surgery, avoiding neuromuscular blockers and sympathetic stimulation may be important to prevent life-threatening arrhythmias.

Limitations

  • Single case report
  • Anesthetic data in the literature are scarce

Cite This Study

Zeka et al. (2022) conducted a case report in Wolff-Parkinson-White Syndrome (n=1). Perioperative management (propofol, sevoflurane, avoiding neuromuscular blockers) was evaluated on Perioperative arrhythmias and hemodynamic stability. Careful perioperative management avoiding sympathetic stimulation and neuromuscular blockers, while using propofol and sevoflurane, resulted in an uneventful surgical course without arrhythmias in a patient with Wolff-Parkinson-White syndrome.

synapsesocial.com/papers/6aa91b22d6272436db5ac9e4https://doi.org/10.7176/alst/95-03
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Sevoflurane Has No Effect on Sinoatrial Node Function or on Normal Atrioventricular and Accessory Pathway Conduction in Wolff-Parkinson-White Syndrome during Alfentanil/Midazolam Anesthesia1999 · 53 citations
  2. 2Electrocardiographic features of Wolff-Parkinson-White syndrome2003 · 27 citations
  3. 3Identification of a Gene Responsible for Familial Wolff–Parkinson–White Syndrome2001 · 677 citations
  4. 4Rome III functional constipation and irritable bowel syndrome with constipation are similar disorders within a spectrum of sensitization, regulated by serotonin.2013 · 2,766 citations