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Indian Journal of Anesthesia and Analgesia

Volume  9, Issue 4, JULY-AUGUST 2022, Pages 183-186
 

Case Report

Continuous Spinal is Safe in a Patient with Wolff-ParkinsonWhite syndrome for Hysterectomy

Monisha B 1 , Ravi Madhusudhana 2 , Nagaseshu Kumari Vasantha 3 , Sinchana Bhagavan 4

1 Resident, 2 Professor & HOD, 3 Assistant Professor, 4 Senior Resident, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.9322.19

Abstract

Introduction: Wolff–Parkinson-White syndrome (WPW) is an uncommon cardiac disorder where there is an  abnormal band of atrial tissue that connects atria and ventricles. Continuous spinal anesthesia is preferred to avoid  multidrug administration and stimulus due to laryngoscopy. Case Report: A 47 yrs old female, known case of WPW syndrome was posted for hysterectomy. Pre-anesthetic  evaluation was done. A 12 lead ECG was done which showed left axis deviation, short PR interval and delta waves.  The 2D – Echo showed thickened MV leaflets with grade-1 MR with normal LV systolic function and EF of 60%.  The case was planned to be taken under continuous spinal anesthesia. The Anti-Arrhythmic drugs and  Defibrillator were kept ready. Intermittent boluses of Inj. Bupivacaine (H) 0.5% was given through catheter to  achieve sensory and motor blockade. Inj. Fentanyl 25mcg was given at the end of the procedure as analgesic dose.  Intra operative vitals were stable. Postoperative period was uneventful. Conclusion: Patient with WPW Syndrome can be managed successfully by continuous spinal anesthesia  technique which uses low dose of anesthetic helps in maintaining cardiovascular stability intraoperatively and  duration can be extended if surgery is prolonged. Keywords: Continuous Spinal Anesthesia, WPW Syndrome, Ventricular Tachycardia. Key Messages: Hemodynamic changes can occur with WPW syndrome with arrhythmias. This can be avoided  with definitive treatment like Radiofrequency ablation. Our patient came with WPW Syndrome with stable  hemodynamics so continuous spinal anesthesia can offer stable hemodynamics with minimum use of local  anesthetics. We are reporting a case of WPW Syndrome with successful anesthetic management


Keywords : Continuous Spinal Anesthesia, WPW Syndrome, Ventricular Tachycardia.
Corresponding Author : Ravi Madhusudhana,