Mena Shayla, Costa Ana, DeLemos Michelle, Schabel Joy, Factor Morgane
Department of Anesthesiology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Road, Health Sciences Center, Level 4, Stony Brook, NY 11794-8434, USA.
Case Rep Anesthesiol. 2022 Jul 15;2022:8940704. doi: 10.1155/2022/8940704. eCollection 2022.
Brugada syndrome is an autosomal dominant disorder that affects cardiac sodium channels and predisposes patients to an increased risk of sudden cardiac death. Obstetric anesthesia management in patients with Brugada syndrome poses a challenge due to the prevalence of local anesthetic use for labor analgesia or cesarean section. However, central neuraxial techniques and local anesthetics have been used safely in parturients with this syndrome and may be offered to patients during preadmission counseling. We present the case of a primigravida who opted for further labor analgesia via a combined spinal-epidural technique. To our knowledge, this is the first case report of a lidocaine infusion administered via an epidural catheter to a laboring parturient with Brugada syndrome. We further discuss the use of local anesthetics, other medications, and central neuraxial techniques in those with Brugada syndrome to assist anesthesiologists caring for expectant mothers.
Brugada综合征是一种常染色体显性疾病，会影响心脏钠通道，并使患者发生心脏性猝死的风险增加。由于分娩镇痛或剖宫产时普遍使用局部麻醉药，Brugada综合征患者的产科麻醉管理面临挑战。然而，椎管内技术和局部麻醉药已在患有该综合征的产妇中安全使用，并且可在入院前咨询期间提供给患者。我们报告一例初产妇选择通过腰麻-硬膜外联合技术进行分娩镇痛的病例。据我们所知，这是首例通过硬膜外导管向患有Brugada综合征的分娩产妇输注利多卡因的病例报告。我们还进一步讨论了Brugada综合征患者局部麻醉药、其他药物及椎管内技术的使用，以帮助麻醉医生护理待产孕妇。
