title: Brugada-type electrocardiographic pattern induced by epidural bupivacaine.
abstract: In this case report, we describe the postoperative occurrence of electrocardiogram changes suggestive for the Brugada syndrome in a patient receiving a continuous epidural bupivacaine infusion. After withdrawal of bupivacaine, the electrocardiogram changes were reversible. The patient's history was unremarkable except for an incomplete right bundle branch block. We conclude that local anesthetics, particularly bupivacaine, have the potential to induce serious arrhythmias in patients with Brugada syndrome.
authors.affiliation: Department of Anesthesia, Westmead Hospital, Australia. nicolephillips@optusnet.com.au
authors.forename: Nicole
authors.initials: N
authors.lastname: Phillips
authors.forename: Mark
authors.initials: M
authors.lastname: Priestley
authors.forename: A Robert
authors.initials: AR
authors.lastname: Denniss
authors.forename: John B
authors.initials: JB
authors.lastname: Uther
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000503:physiopathology; D001794:Blood Pressure; D002037:Bundle-Branch Block / Q000139:chemically induced / Q000503:physiopathology; D002045:Bupivacaine / Q000009:adverse effects*; D004562:Electrocardiography / Q000187:drug effects*; D005080:Exercise Test; D005743:Gastrectomy; D006801:Humans; D008297:Male; D013274:Stomach Neoplasms / Q000601:surgery
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine