Key result
Combined interscalene block and general anesthesia maintains electrical and hemodynamic stability in Brugada syndrome.
Why the study?
Perioperative pharmacological and physiological changes in patients with Brugada syndrome may precipitate malignant ventricular arrhythmias and sudden cardiac death, requiring evaluation of anesthesia safety.
Does interscalene plexus block combined with general anesthesia provide safe and effective anesthesia in a patient with Brugada syndrome?
Case Report (n=1)
Does interscalene plexus block combined with general anesthesia provide safe and effective anesthesia in a patient with Brugada syndrome?
Interscalene block combined with general anesthesia appears safe and provides hemodynamic and electrical stability in patients with Brugada syndrome.
Answers are grounded in this paper and cite their sources.
Supports feasibility of interscalene block with GA in BrS; leaves open need for confirmatory studies.
Brugada syndrome (BrS) is a channelopathy predisposing to malignant ventricular arrhythmias and sudden cardiac death. Perioperative pharmacological and physiological changes may precipitate these events and cardiac dysfunction. We report the efficacy and safety interscalene brachial plexus block combined with general anesthesia in a patient with BrS. Awake and double-guided interscalene block was performed. After performing the block, general anesthesia was induced with fentanyl, propofol and rocuronium and maintained with oxygen-air/sevoflurane mixture. Sugammadex was administered for neuromuscular reversal. During perioperative period, the patient remained hemodynamically stable with anormal sinus rhythm and no ST segment changes. Hospital discharged occurred 36h after surgery without complications. General recommendations include avoidance of increased vagal tone, correction of electrolytes disturbances, maintenance of normothermia, normocapnia, adequate analgesia, and an adequately deep plane of anesthesia. Interscalene block combined with general anesthesia provided good analgesia, hemodynamic and cardiac electric stability.
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Ferreira et al. (2019) conducted a case report in Brugada syndrome (n=1). Interscalene brachial plexus block combined with general anesthesia was evaluated on Hemodynamic and cardiac electric stability, and complications. Interscalene block combined with general anesthesia provided good analgesia, hemodynamic stability, and cardiac electric stability in a patient with Brugada syndrome without complications.
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