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KMID : 0980320230230010045
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Journal of Dental Anesthesia and Pain Medicine
2023 Volume.23 No. 1 p.45 ~ p.51
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General anesthesia using propofol infusion for implantation of an implantable cardioverter defibrillator in a pediatric patient with Andersen-Tawil syndrome: a case report
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Park Se-Yeon
Heo Won-Jae
Shin Sang-Wook
Kim Hye-Jin
Yoo Yeong-Min
Kim Hee-Young
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Abstract
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Andersen-Tawil syndrome (ATS) is a rare genetic disease characterized by a triad of episodic flaccid muscle weakness, ventricular arrhythmias, and physical anomalies. ATS patients have various cardiac arrhythmias that can cause sudden death. Implantation of an implantable cardioverter-defibrillator (ICD) is required when life-threatening cardiac arrhythmias do not respond to medical treatment. An 11-year-old girl underwent surgery for an ICD implantation. For general anesthesia in ATS patients, anesthesiologists should focus on the potentially difficult airway, serious cardiac arrhythmias, such as ventricular tachycardia (VT), and delayed recovery from neuromuscular blockade. We followed the difficult airway algorithm, avoided drugs that can precipitate QT prolongation and fatal cardiac arrhythmias, and tried to maintain normoxia, normocarbia, normothermia, normoglycemia, and pain control for prevention of sympathetic stimulation. We report the successful application of general anesthesia for ICD implantation in a pediatric patient with ATS and recurrent VT.
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KEYWORD
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Andersen-Tawil Syndrome, Anesthesia, Implantable Cardioverter Defibrillator, Long QT Syndrome, Propofol
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