Anesthesia and Brugada syndrome: a 12-year case series.
OBJECTIVE
The aim of this 12-year case series was to review the drugs used during anesthetic management of patients with diagnosis of or risk criteria for Brugada syndrome (BrS), and to document any possible association between these drugs and arrhythmogenic activity or unexplained hemodynamic instability.


METHODS
A retrospective clinical observational study.


METHODS
Tertiary hospital.


METHODS
Thirty-one patients met our inclusion criteria: 20 belonging to group D (diagnosed BrS) and 11 to group R (risk of BrS). They underwent a total of 43 anesthetic interventions (28 in group D and 15 in group R).


METHODS
Records from patients with or at risk of BrS who underwent anesthetic intervention at our hospital between May 2003 and May 2015 were retrospectively reviewed. Drugs used were compared with those recommended to be avoided or preferably avoided, published by specialists in the field at brugadadrugs.org.


METHODS
Hemodynamic and cardiac complications during anesthesia were assessed for hypothetical association with these drugs.


RESULTS
From the list of drugs available in medical literature recommended to avoid in BrS patients the following were used in our series: propofol (n = 8 in group D, n = 8 in group R), local anesthetics (n = 15 in group D, n = 8 in group R), tramadol (n = 1 in group D), and metoclopramide (n = 1 in group D). Hemodynamic complications occurred in 5 procedures, but no direct association was found between these events and the use of the drugs listed above.


CONCLUSIONS
Major adverse events related to the deleterious effects of drugs recommended to be avoided were not detected in our series of patients with or at risk of BrS. Although authors cannot refute the theoretical risk of major adverse advents when using known or potential BrS triggers, the true clinical risk of these drugs is unknown, and recommendations to avoid their use should be better supported.
Anesthesiology Department, Centro Hospitalar Tondela-Viseu, Avenida Rei D. Duarte, 3504 509, Viseu, Portugal. Electronic address: melanieduque@gmail.com.
Mélanie
M
Duque
Cardiology Department, Centro Hospitalar Tondela-Viseu, Avenida Rei D. Duarte, 3504 509, Viseu, Portugal. Electronic address: luisferreirasantos@gmail.com.
Luís
L
Santos
Anesthesiology Department, Centro Hospitalar Tondela-Viseu, Avenida Rei D. Duarte, 3504 509, Viseu, Portugal. Electronic address: sandy.ribeiro@sapo.pt.
Sandy
S
Ribeiro
Anesthesiology Department, Centro Hospitalar Tondela-Viseu, Avenida Rei D. Duarte, 3504 509, Viseu, Portugal. Electronic address: doracatre@gmail.com.
Dora
D
Catré
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D000777:Anesthetics / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D053840:Brugada Syndrome / Q000139:chemically induced* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects; D008875:Middle Aged; D015742:Propofol / Q000009:adverse effects; D012189:Retrospective Studies; D014147:Tramadol / Q000009:adverse effects; D055815:Young Adult
D000701:Analgesics, Opioid; D000777:Anesthetics; D018686:Anesthetics, Intravenous; D014147:Tramadol; D008787:Metoclopramide; D015742:Propofol
Anesthesia; Brugada syndrome; Case series; Complications