REVIEW   Free access

Minerva Anestesiologica 2019 February;85(2):173-88

DOI: 10.23736/S0375-9393.18.13170-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Brugada Syndrome: anesthetic considerations and management algorithm

Ángel ESPINOSA ^{1, 2}, Javier RIPOLLÉS-MELCHOR ^{2, 3, 4, 5} ✉, Ramón BRUGADA ^{6, 7, 8, 9}, Óscar CAMPUZANO ^{6, 7, 8}, Georgia SARQUELLA-BRUGADA ^{7, 10, 11}, Ane ABAD-MOTOS ^{3, 4, 5}, Matilde ZABALLOS-GARCÍA ^{12, 13}, Ana ABAD-TORRENT ¹⁴, Alejandra PRIETO-GUNDIN ¹⁵, Josep BRUGADA ^{10, 11}

¹ Department of Cardiothoracic Anesthesia, Mohammed Bin Khalifa Bin Salman Al Khalifa Cardiac Center, Royal Medical Services, Awali, Bahrain; ² Evidence Anesthesia Review Group (EAR), Department of Pharmacology, Faculty of Medicine of Complutense University of Madrid, Madrid, Spain; ³ Department of Anesthesiology and Critical Care, Infanta Leonor University Hospital, Madrid, Spain; ⁴ Madrid Complutense University, Madrid, Spain; ⁵ Spanish Perioperative Audit and Research Network (RedGERM), Zaragoza, Spain; ⁶ Cardiovascular Genetics Center, Girona Biomedical Research Institute (IDIBGI), University of Girona, Girona, Spain; ⁷ Department of Medical Sciences, School of Medicine, University of Girona, Girona, Spain; ⁸ Cardiovascular Diseases Network Biomedical Research Center (CIBERCV), Madrid, Spain; ⁹ Department of Cardiology, Josep Trueta Hospital, Girona, Spain; ¹⁰ Unit of Pediatric Arrhythmia, Department of Cardiology, Sant Joan de Déu Hospital, Barcelona, Spain; ¹¹ Section of Arrhythmia, Department of Cardiology, Clinic Hospital, University of Barcelona, Barcelona, Spain; ¹² Department of Anesthesiology, Gregorio Marañón University General Hospital, Madrid, Spain; ¹³ Clinical Toxicology, Madrid Complutense University, Madrid, Spain; ¹⁴ Department of Anesthesiology, Vall d’Hebron University Hospital, Barcelona, Spain; ¹⁵ Department of Pediatric Anesthesiology, Sant Joan de Déu Hospital, Barcelona Children’s Hospital, Barcelona, Spain

Brugada Syndrome is characterized by arrhythmogenic risk that may be exacerbated by different metabolic and pharmacological factors. Since its first description, knowledge of this syndrome and its detection by physicians belonging to different specialties have gradually increased. The risk of arrhythmias is well known to increase in the postoperative period, and this risk is particularly accentuated in patients with Brugada Syndrome. The purpose of this review is to analyze the relationship between this syndrome and anesthesia; establish recommendations for the safe management of these patients in the surgical setting; and update the relevant concepts regarding the safety of drug administration in individuals with Brugada Syndrome.

KEY WORDS: Perioperative care - Anesthesia - Electrocardiography - Brugada Syndrome