Sreckovic Svetlana, Lemic Jana, Vitomirovic Katarina, Vukman Petar, Glisovic Jovanovic Ivana
Anesthesiology, University of Belgrade, Belgrade, SRB.
Anesthesiology and Reanimation, University Clinical Centre of Serbia, Belgrade, SRB.
Cureus. 2025 May 27;17(5):e84874. doi: 10.7759/cureus.84874. eCollection 2025 May.
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmia syndrome affecting the structurally normal heart, occurring during high adrenaline levels triggered by exercise or emotional stress. CPVT results from a mutation in the gene and is clinically characterized by episodes of syncope, arrhythmias, or sudden cardiac arrest. Optimal perioperative preparation for patients with CPVT aims to prevent increases in catecholamine levels during venipuncture, surgery, and pain management. Levobupivacaine, a long-lasting local anesthetic, was administered to a 28-year-old female patient for an axillary nerve block during orthopedic surgery. The patient had experienced sudden cardiac arrest at the age of 24, where the gene mutation was confirmed, leading to the initiation of beta-blocker therapy. Subsequent hypoxic-ischemic encephalopathy, resulting from resuscitation, caused spastic quadriplegia. The patient's vital parameters, such as electrocardiogram, non-invasive blood pressure (NIBP), and oxygen saturation (SpO2), were monitored throughout the perioperative period. Orthopedic surgery was successfully completed, with no changes observed in the electrocardiogram. Levobupivacaine, being less cardiotoxic, ensured good intraoperative conditions without adverse events and provided adequate postoperative pain control for the patient with CPVT during orthopedic surgery.
儿茶酚胺能多形性室性心动过速（CPVT）是一种罕见的遗传性心律失常综合征，影响结构正常的心脏，在运动或情绪应激引发的高肾上腺素水平时发作。CPVT由该基因的突变引起，临床特征为晕厥、心律失常或心脏骤停发作。CPVT患者的最佳围手术期准备旨在防止静脉穿刺、手术和疼痛管理期间儿茶酚胺水平升高。左旋布比卡因是一种长效局部麻醉剂，在骨科手术期间用于一名28岁女性患者的腋神经阻滞。该患者在24岁时经历过心脏骤停，已证实存在该基因突变，因此开始接受β受体阻滞剂治疗。复苏导致的后续缺氧缺血性脑病引起了痉挛性四肢瘫痪。在整个围手术期监测患者的重要参数，如心电图、无创血压（NIBP）和血氧饱和度（SpO2）。骨科手术成功完成，心电图未观察到变化。左旋布比卡因心脏毒性较小，确保了良好的术中条件且无不良事件发生，并为骨科手术期间的CPVT患者提供了充分的术后疼痛控制。
