The use of sugammadex in a pregnant patient with Wolff-Parkinson-White syndrome
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- 作者：Turker Sengul ; MD ; turker.sengul@gmail.com" class="auth_mail" title="E-mail the corresponding author (Assistant Professor) ; Ayten Saracoglu ; MD (Associate Professor) ; Sibel Sener ; MD (Assistant Professor) ; Olgac Bezen ; MD (Assistant Professor)
- 关键词：Wolff Parkinson White ; Sugammadex ; Cesarean section
- 刊名：Journal of Clinical Anesthesia
- 出版年：2016
- 出版时间：September 2016
- 年：2016
- 卷：33
- 期：Complete
- 页码：1-4
- 全文大小：304 K
文摘
Wolff-Parkinson-White (WPW) syndrome is a rare pre-excitation syndrome which develops when atrioventricular conduction occurs through a pathologic accessory pathway known as the bundle of Kent instead of atrioventricular node, hence resulting in tachycardia. Patients with WPW syndrome may experience various symptoms arising from mild-to-moderate chest disease, palpitations, hypotension, and severe cardiopulmonary dysfunction. These patients are most often symptomatic because of cardiac arrhythmias. In this case report, we present an uneventful anesthetic management of a pregnant patient with WPW syndrome undergoing cesarean delivery. A 23-year-old American Society of Anesthesiologists class 2 pregnant patient was diagnosed with WPW syndrome. Her preoperative 12-lead electrocardiogram showed a sinus rhythm at 82 beats per minute, a delta wave, and a short PR interval. After an uneventful surgery, sugammadex 2 mg/kg was administered as a reversal agent instead of neostigmine. Then she was discharged to her obstetrics service. Serious hemodynamic disorders may occur in patients with WPW syndrome due to development of fatal arrhythmias. Neostigmine used as a reversal agent in general anesthesia can trigger such fatal arrhythmias by leading changes in cardiac conduction. We believe that sugammadex, which is safely used in many areas in the scope of clinical practice, can be also used for patients diagnosed with WPW syndrome.