CASE REPORT
Year : 2019  |  Volume : 13  |  Issue : 4  |  Page : 371-373

Interscalene plexus block and general anesthesia in Brugada syndrome


1 Department of Anesthesiology, Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Portugal
2 Department of Anesthesiology, Centro Hospitalar do Porto, Portugal

Correspondence Address:
Dr. Monica Nunes Ferreira
Rua António da Costa Viseu Número 108 – 4°esquerdo, 4435 -104 Rio Tinto
Portugal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.SJA_47_19

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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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