Anaesthesia for caesarean section in a patient with Jervell, Lange-Nielsen syndrome.
The anaesthetic management of a patient with Jervell, Lange-Nielsen syndrome (a form of congenitally prolonged QT interval) requiring emergency Caesarean section is presented. An epidural anaesthetic using 3-chloroprocaine produced a safe and satisfactory anaesthetic for the procedure in a patient prone to ventricular arrhythmias and cardiac arrest. High levels of circulating catecholamines have been postulated as one of the causes of the arrhythmias in these patients, making it advisable to select drugs and techniques known to minimize catecholamine levels. Although communication can be difficult in these profoundly deaf patients, it is important in order to reduce the emotional stress. Elective Caesarean sections under general anaesthesia have been reported; it appears that a well planned regional anaesthetic is equally safe.
Ryan
H
H
Department of Anaesthesia, University Hospital, College of Medicine, Saskatoon, Saskatchewan.
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D002585:Cesarean Section; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011343:Procaine / Q000031:analogs & derivatives
D011343:Procaine; C004616:chloroprocaine