1/6. Idiopathic prolonged QT interval and QT dispersion: the effects of propofol during implantation of cardioverter-defibrillator.Local anaesthesia combined with conscious sedation is becoming a popular technique for implantation of cardioverter-defibrillator devices. propofol was given to provide loss of consciousness during defibrillation shock administration, for induced ventricular fibrillation testing. propofol was found to decrease QT interval and QT dispersion in two patients with idiopathic prolonged QT interval and QT dispersion. The findings of the procedure are reported.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/6. Anaesthetic-induced ventricular tachyarrhythmia in Jervell and Lange-Nielsen syndrome.A four-year-old deaf girl with a history of convulsions developed polymorphous ventricular tachycardia during induction of anaesthesia. The arrhythmia reverted to sinus rhythm spontaneously. Post-anaesthetic ECG showed marked prolongation of the QTc interval (570-690 msec). deafness and prolonged QTc interval in association with microcytic-hypochromic anaemia confirmed the diagnosis of the Jervell and Lange-Nielsen syndrome. This case report highlights the potentially lethal complication of halothane anaesthesia in patients with long QTc interval syndrome.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
3/6. Anaesthesia for caesarean section in a patient with Jervell, Lange-Nielsen syndrome.The anaesthetic management of a patient with Jervell, Lange-Nielsen syndrome (a form of congenitally prolonged QT interval) requiring emergency Caesarean section is presented. An epidural anaesthetic using 3-chloroprocaine produced a safe and satisfactory anaesthetic for the procedure in a patient prone to ventricular arrhythmias and cardiac arrest. High levels of circulating catecholamines have been postulated as one of the causes of the arrhythmias in these patients, making it advisable to select drugs and techniques known to minimize catecholamine levels. Although communication can be difficult in these profoundly deaf patients, it is important in order to reduce the emotional stress. Elective Caesarean sections under general anaesthesia have been reported; it appears that a well planned regional anaesthetic is equally safe.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/6. Cardiac arrest under anaesthesia in a child with previously undiagnosed Jervell and Lange-Nielsen syndrome.A 7-year-old Sikh boy with a history of syncopal attacks and congenital deafness was admitted for elective adenoidectomy and examination of his ears under general anaesthesia. Immediately after induction of anaesthesia an ECG demonstrated T wave inversion in the CM5 lead. The child subsequently developed multifocal ventricular extrasystoles and later, ventricular fibrillation. Defibrillation was achieved using two 50 J DC shocks. A 12-lead ECG performed later demonstrated a prolonged Q-Tc interval (0.52 s). The child was diagnosed as having the Jervell and Lange-Nielsen syndrome.- - - - - - - - - - ranking = 6keywords = anaesthesia (Clic here for more details about this article) |
5/6. Sudden cardiorespiratory arrest after renal transplantation in a patient with diabetic autonomic neuropathy and prolonged QT interval.A 31-yr male with insulin dependent diabetes mellitus for 20 years underwent general anaesthesia for renal transplantation. During transfer from operating theatre to ICU he developed bradycardia advancing to ventricular fibrillation and had to be resuscitated. bradycardia did not respond to atropine. Postoperative autonomic nervous function tests showed advanced autonomic neuropathy. He was found to have constantly prolonged QTc interval in his pre- and postoperative ECGs (462-503 ms). Prolongation of QTc interval could be used as a valuable predictor of postoperative cardiac complications in diabetic patients with autonomic neuropathy.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
6/6. Long QT interval syndrome with increased QT dispersion.This case report describes the anaesthetic management of a patient with sporadic-type long QT interval syndrome (LQTS), and increased QT dispersion, who presented for removal of an ovarian cyst. Beta adrenergic blockade and adequate depth of anaesthesia for successful management is emphasized. The successful use of epidural administration of lignocaine and opioids in addition to general anaesthesia is described.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |