Brugada syndrome is an arrhythmic syndrome characterized by right bundle branch block, ST segment elevation in the precordial lead (V1-V3), and sudden death caused by ventricular fibrillation, which is not effectively prevented by anti-arrhythmic drug therapy. We are reporting a 30-year-old male patient with Brugada syndrome who got an exploratory laparotomy and a tenorrhaphy due to stab wound which was managed with general anesthesia and brachial plexus block without any complications.
A healthy 35-year-old man who was scheduled for closed reduction of nasal bone fracture developed atrial fibrillation during induction of general anesthesia after intravenous glycopyrrolate injection. During emergence of general anesthesia, atrial fibrillation was suddenly changed to paroxysmal supraventricular tachycardia with 200 beat per minute and lasted for about 10 seconds. Because blood pressure was stable, esmolol was used to reduce ventricular response. At recovery room, ventricular response reduction about 55 beat per minute was observed after intravenous injection of verapamil 5 mg. Thereafter, the rhythm was returned to normal sinus rhythm with bradycardia.