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The unique challenges of Brugada syndrome in spinal deformity surgery
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Orthopedic Surgery.ORCID iD: 0000-0002-7376-4664
Department of Anesthesia and Intensive Care, Örebro University School of Medical Sciences, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences. Department of Pediatrics.
Örebro University, School of Medical Sciences. Department of Orthopedic Surgery.ORCID iD: 0000-0002-3905-7210
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2021 (English)In: Interdisciplinary Neurosurgery, E-ISSN 2214-7519, Vol. 25, article id 101281Article in journal (Refereed) Published
Abstract [en]

Brugada Syndrome (BrS) is a genetic condition associated with ventricular fibrillation and sudden cardiac death. In BrS, several pharmacological agents may increase the risk for arrhythmia and total intravenous anesthesia with propofol (TIVA) may be contraindicated due to the increased risk of perioperative cardiac arrest. Anesthesia with halogenated volatile agents has to be used instead, making monitoring of sensory and motor evoked potentials in spine surgery problematic. Furthermore, hyperthermia may induce ventricular arrhythmia in BrS, thus making temperature control of paramount importance. The purpose of this paper is to describe the particular challenges of anesthesia and intraoperative neuromonitoring associated with corrective spinal surgery in an adolescent girl with BrS. We present an analysis of a multidisciplinary approach to performing corrective spine surgery in an otherwise healthy 14-year-old girl with scoliosis. Before surgery, multidisciplinary meetings were conducted, including anesthesia and intensive care, pediatric cardiology as well as the spine team. The surgery was performed with inhalation anesthesia using sevoflurane and cardiac monitoring. Continuous somatosensory potentials were monitored as well as motor evoked potentials. The patient underwent corrective surgery from Th3 to L2. With a multidisciplinary team approach involving anesthesia and cardiology outlining the appropriate precautions, scoliosis correction with intraoperative neuromonitoring, can be safely performed in patients with BrS using inhalation anesthesia.

Place, publisher, year, edition, pages
Elsevier, 2021. Vol. 25, article id 101281
Keywords [en]
Spinal deformity, Adolescent idiopathic scoliosis, Brugada Syndrome, Intraoperative neuromonitoring
National Category
Neurology Surgery
Identifiers
URN: urn:nbn:se:oru:diva-93748DOI: 10.1016/j.inat.2021.101281ISI: 000679389600011Scopus ID: 2-s2.0-85107275907OAI: oai:DiVA.org:oru-93748DiVA, id: diva2:1586276
Available from: 2021-08-19 Created: 2021-08-19 Last updated: 2021-08-19Bibliographically approved

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Sigmundsson, Freyr GautiFadl, ShalanHoly, MarekJoelson, Anders

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