Pegu B, Singh R. Anesthetic management of a young primigravida a case of symptomatic long QT syndrome with a permanent pacemaker
in-situ undergoing lower segment cesarean section delivery: A case report.
Saudi J Anaesth 2023;
17:256-259. [PMID:
37260636 PMCID:
PMC10228844 DOI:
10.4103/sja.sja_688_22]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 09/25/2022] [Indexed: 06/02/2023] Open
Abstract
The patient with Long QT syndrome (LQTS) presents a unique challenge to the anesthesiologist. The anesthetic management of such patients requires a good knowledge of the pathophysiology of this rare disease. General anesthesia (GA) or combined spinal epidural anesthesia (CSEA) are the most preferred anesthetic techniques among anesthesiologists for such patients posted for the lower segment cesarean section delivery. In this report, we would like to share our experience of anesthetic management of a young primigravida, a case of symptomatic LQTS with a permanent pacemaker in situ. Anesthetic technique used for the lower segment cesarean section delivery was single-shot spinal anesthesia using a combination of a local anesthetic and strong opioid in the lumber subarachnoid space. Until recently, only one report in the literature has described this single-shot spinal technique for such cases. The advantages of single shot spinal over GA and CSEA can be utilized in a select group of these patients, which include fast onset, dense, reliable block with low local anesthetic toxicity, reduced catecholamine release, and relatively prolonged analgesia when combined with an opioid.
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