Femenía F, Ruiz-Gimeno J I, Ferre M A, Cabezudo L, Vivó C, Barberá M
Servicio de Anestesiología y Reanimación, Hospital Universitario La Fe, Valencia.
Rev Esp Anestesiol Reanim. 2008 Jun-Jul;55(6):367-70. doi: 10.1016/s0034-9356(08)70593-0.
We report the case of a 27-year-old woman with congenital long QT syndrome (LQTS) who was scheduled for surgery to reposition an implantable defibrillator. Given the risk of sudden death due to fatal ventricular arrhythmia, the woman required implantation of a defibrillator with pacemaker capability. Combined anesthesia-analgesia was used in order to minimize the risk of ventricular arrhythmia caused by increased serum concentrations of catecholamines. When cardioversion, defibrillation and anti-tachycardia functions had been deactivated, anesthesia was induced with propofol, fentanyl and rocuronium. Anesthesia was maintained with an infusion of propofol and remifentanil. We describe the pathophysiology and treatment of LQTS and discuss anesthetic management for repositioning a defibrillator in a patient with congenital LQTS.
我们报告了一例27岁先天性长QT综合征（LQTS）女性患者的病例，该患者计划接受手术以重新放置植入式除颤器。鉴于存在因致命性室性心律失常导致猝死的风险，该女性需要植入具有起搏功能的除颤器。为了将儿茶酚胺血清浓度升高引起室性心律失常的风险降至最低，采用了联合麻醉-镇痛。在心脏复律、除颤和抗心动过速功能停用后，用丙泊酚、芬太尼和罗库溴铵诱导麻醉。通过输注丙泊酚和瑞芬太尼维持麻醉。我们描述了LQTS的病理生理学和治疗方法，并讨论了为先天性LQTS患者重新放置除颤器的麻醉管理。
