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Regional Anesthesia in Brugada Syndrome-Worth the Risk? A Dual-Case Report
Kelsey M Repine1, Grace E Tooley2, Britni Beagley3
1From the Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado.
A&A Practice
|July 14, 2025
Summary
Patients with Brugada syndrome require careful anesthetic management due to cardiac risks. This case study highlights successful anesthetic strategies for shoulder arthroplasty in a patient with Brugada syndrome.
Area of Science:
- Anesthesiology
- Cardiology
- Genetics
Background:
- Brugada syndrome poses significant anesthetic challenges due to increased risk of ventricular fibrillation and cardiac arrest.
- Local anesthetics are contraindicated in Brugada syndrome patients as they target sodium channels, which are dysfunctional in this condition.
Purpose of the Study:
- To present the anesthetic management of a patient with Brugada syndrome undergoing consecutive total shoulder arthroplasties.
- To illustrate the successful application of different regional anesthesia techniques in a high-risk patient.
Main Methods:
- The patient underwent two consecutive total shoulder arthroplasties under general anesthesia.
- The first surgery utilized a continuous nerve block catheter for analgesia.
- The second surgery employed a single-shot nerve block for pain management.
Main Results:
- Both anesthetic approaches were successfully implemented without adverse cardiac events.
- The multidisciplinary team approach ensured comprehensive patient care throughout the perioperative period.
Conclusions:
- Anesthetic management for Brugada syndrome patients requires meticulous planning and a collaborative approach.
- Regional anesthesia techniques, when carefully selected, can be safely employed in Brugada syndrome patients undergoing surgery.
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