Saito Kurumi, Yoshida Hitoshi, Hirota Kazuyoshi
Department of Anesthesiology, Hirosaki General Medical Center, 1 Tomino-Cho, Hirosaki, 036-8174, Japan.
Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, 036-8562, Japan.
JA Clin Rep. 2024 Mar 12;10(1):18. doi: 10.1186/s40981-024-00702-7.
During general anesthesia, patients with Brugada syndrome are at risk of malignant arrhythmias following worsened ST-segment elevation, potentially leading to sudden cardiac death. The protocol for safe anesthetic management of patients with Brugada syndrome has not yet been established.
A 63-year-old man, diagnosed with a spontaneous Brugada type 1 pattern, was scheduled for a pleural biopsy using video-assisted thoracoscopic surgery under general anesthesia. We planned general anesthesia using volatile induction and maintenance anesthesia with sevoflurane and remifentanil. We monitored ST-segment morphology and observed sustained mitigation of ST-segment elevation throughout general anesthesia.
The present case may indicate that safe anesthetic management of patients with Brugada syndrome depends on whether the anesthetics used can reduce ST-segment elevation.
在全身麻醉期间， Brugada综合征患者有发生ST段抬高加重后恶性心律失常的风险，这可能导致心源性猝死。Brugada综合征患者安全麻醉管理的方案尚未确立。
一名63岁男性，诊断为自发性1型Brugada图形，计划在全身麻醉下使用电视辅助胸腔镜手术进行胸膜活检。我们计划采用挥发性诱导和七氟醚及瑞芬太尼维持麻醉的全身麻醉方式。我们监测了ST段形态，并观察到在整个全身麻醉过程中ST段抬高持续减轻。
本病例可能表明，Brugada综合征患者的安全麻醉管理取决于所用麻醉剂是否能降低ST段抬高。
