Anesthesia for Wolff-Parkinson-White syndrome: A report of two cases

Namshikar, Viraj; Bharne, Sidhesh

doi:10.4103/1658-354x.115342

Cited by 3 publications

(7 citation statements)

References 5 publications

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“…Dose titration and gradual elevation of the block can be achieved with lumbar epidural and combined low-dose-spinal/epidural anaesthesia. These modalities offer more haemodynamic stability and should probably be preferred over single-shot spinal anaesthesia [81]. There are several reports of operations (caesarean deliveries included) performed safely under a simple epidural [64,[82][83][84] or a combined spinal/epidural anaesthesia [81,[85][86][87][88].…”

Section: Anaesthesia For Non-ablative Surgical Proceduresmentioning

confidence: 99%

“…These modalities offer more haemodynamic stability and should probably be preferred over single-shot spinal anaesthesia [81]. There are several reports of operations (caesarean deliveries included) performed safely under a simple epidural [64,[82][83][84] or a combined spinal/epidural anaesthesia [81,[85][86][87][88]. In selected cases, combined general/regional anaesthesia may be used; successful thoracotomy under propofol anaesthesia together with thoracic epidural analgesia has been reported [61].…”

Section: Anaesthesia For Non-ablative Surgical Proceduresmentioning

confidence: 99%

“…Both ephedrine and phenylephrine have been used to treat hypotension [18,81,86,90]. Moreover, phenylephrine was reported to resolve a paroxysmal SVT resistance to various other measures and drugs [91].…”

Section: Management Of Perioperative Arrhythmiasmentioning

confidence: 99%

“…Electrical synchronised cardioversion is indicated for SVT or AF resistant to antiarrhythmic drugs or in cases with extreme tachycardia and/or hypotension/ shock, myocardial ischaemia, heart failure/pulmonary oedema or syncope [17,59,81,97,98]. Immediate defibrillation should be performed in VF or pulseless VT [97].…”

Section: Management Of Perioperative Arrhythmiasmentioning

confidence: 99%

“…Immediate defibrillation should be performed in VF or pulseless VT [97]. Antiarrhythmic drugs and a defibrillator should be prepared before anaesthesia induction [57,81].…”

Section: Management Of Perioperative Arrhythmiasmentioning

confidence: 99%

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erioperative management of patients with pre-excitation syndromes

2018

Rom J Anaesth Int Care

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Patients with pre-excitation abnormalities are at a high risk for life-threatening perioperative arrhythmias. In Wolff-Parkinson-White syndrome, the anaesthetics used for invasive diagnostic testing/ablation, should not affect cardiac electrophysiology; propofol, sevoflurane, fentanyl, sufentanil , alfentanil are suitable. In non-ablative surgery, propofol, sevoflurane, isoflurane, fentanyl, alfentanil, sufentanil have been used safely. Among neuromuscular blockers, cis-atracurium, rocuronium and vecuronium are good choices. Ketamine, pancuronium and pethidine should be avoided because of their sympathomimetic actions. Anticholinergic/ anticholinesterase combinations for neuromuscular block reversal should preferably be omitted, while sugammadex seems more attractive. In regional anaesthesia, addition of epinephrine and high sympathetic blocks should be avoided. Hypotension should be treated with pure alpha-adrenergic agonists. Other preexcitation abnormalities associated with different accessory pathways are the Mahaim Fiber and Lown-Ganong-Levine syndrome. Sympathetic activation should be avoided. Total intravenous anaesthesia with propofol probably represents the safest option. A careful anaesthetic plan and close cooperation with cardiologists are mandatory for successful management.

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Section: Anaesthesia For Non-ablative Surgical Proceduresmentioning

confidence: 99%

Section: Anaesthesia For Non-ablative Surgical Proceduresmentioning

confidence: 99%

Section: Management Of Perioperative Arrhythmiasmentioning

confidence: 99%

Section: Management Of Perioperative Arrhythmiasmentioning

confidence: 99%

“…Immediate defibrillation should be performed in VF or pulseless VT [97]. Antiarrhythmic drugs and a defibrillator should be prepared before anaesthesia induction [57,81].…”

Section: Management Of Perioperative Arrhythmiasmentioning

confidence: 99%

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erioperative management of patients with pre-excitation syndromes

2018

Rom J Anaesth Int Care

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Wolff–Parkinson–White syndrome: Implications for an anaesthesiologist

Udaybhaskar

Sreemayee

Ingley

2017

Journal of Neuroanaesthesiology and Critical Care

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Wolff–Parkinson–White (WPW) syndrome is an electrical conduction abnormality of the heart that can induce potentially fatal arrhythmias at intermittent intervals. The induction and maintenance of general anaesthesia for a patient with WPW syndrome are risky due to the triggering capability of arrhythmias by various drugs and instrumentation. We hereby present the case of a 28-year-old male with previous cardiac illness, admitted for neurosurgical procedure, with drug-controlled WPW syndrome. The pre-operative optimisation, intraoperative scrutiny and vigil, along with readiness of standby medications and defibrillator made the ingress and egress from general anaesthesia uneventful. Thus, the potential dangers of WPW syndrome can be circumvented with watchful preparedness and meticulous monitoring.

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Anesthetic Management of an Obstetric Patient With Ehlers-Danlos and Wolff-Parkinson-White Syndromes

Biladeau,

Bocard,

Grell

2023

Cureus

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A 31-year-old, primigravida, nullipara (G1P0) female with a past medical history of Ehlers-Danlos Syndrome (EDS), newly diagnosed Wolff-Parkinson-White Syndrome (WPW), and fetal breech presentation initially presented at 36+5 weeks gestation for an external cephalic version (ECV). The patient noted significant symptomatology related to her WPW which had worsened over the course of her pregnancy despite being started on oral metoprolol. Despite joint recommendations from the anesthesia and obstetric teams to combine the ECV with a same-day scheduled induction of labor or cesarean section, the patient declined. An epidural catheter was placed using ultrasound guidance and slowly titrated with 2% lidocaine; however, the ECV was unsuccessful. At 39 weeks gestation, the patient underwent an uncomplicated low transverse cesarean section under combined spinal-epidural anesthesia. The patient was discharged two days later in stable condition with a referral to an electrophysiologist. Here we describe the anesthetic preparation and management for an external cephalic version and subsequent cesarean section in a patient with these two rare conditions.

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Anesthesia for Wolff-Parkinson-White syndrome: A report of two cases

Cited by 3 publications

References 5 publications

erioperative management of patients with pre-excitation syndromes

erioperative management of patients with pre-excitation syndromes

Wolff–Parkinson–White syndrome: Implications for an anaesthesiologist

Anesthetic Management of an Obstetric Patient With Ehlers-Danlos and Wolff-Parkinson-White Syndromes

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