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Updated: Jan 5, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Recurrent syncope in a child and video assisted thoracoscopic surgery - The long and short of it
Manpreet Kaur1, Nirupa Ramakumar1, Sangam Yadav1
1Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Insights
Managing Long QT syndrome (LQTS) during surgery is complex. This case study details anesthetic management for a child with LQTS undergoing thoracoscopic sympathectomy, highlighting challenges in lung isolation and preventing torsades de pointes.
Area of Science:
- Cardiology
- Anesthesiology
- Pediatric Surgery
Background:
- Long QT syndrome (LQTS) is a cardiac ion channelopathy affecting myocardial repolarization, often presenting as syncope.
- Reduced repolarization reserve in LQTS can be exacerbated by perioperative factors including electrolyte imbalance, drugs, hypothermia, and autonomic tone changes.
Abstract:
Long QT syndrome (LQTS) is a myocardial repolarisation disorder caused by cardiac ion channelopathy and one of its common presentations is recurrent syncope. This reduced repolarisation reserve in LQTS can be unmasked by perioperative factors like electrolyte imbalance, drugs, hypothermia and changes in cardiac autonomic tone. We report the anaesthetic management of left thoracoscopic sympathectomy in a 5-year-old child with LQTS and epicardial pacemaker in situ. It is very challenging to isolate the lung on one hand and prevent the predisposition to torsadogenic potential on the other.
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