Anesthetic Management of Prolonged Q-T Interval Syndrome

Abstract

The pre- and intraoperative management of a patient who had prolonged Q-T interval syndrome was reported. The successful anesthetic management of a patient who has prolonged Q-T interval syndrome depends on several factors. Any condition that might aggravate an already prolonged Q-T interval should be avoided. Drugs that prolong the Q-T interval include quinidine, lidocaine, procainamide and some phenothiazines. These medications, therefore, must be used with extreme caution. Since this list contains the most commonly used antiarrhythmics, intraoperative arrhythmias may be especially difficult to treat. The drugs that were most effective in the treatment of the disease were diphenylhydantoin and propranolol, but their benefits were inconsistent. Cardiac stability was the major factor in determining the anesthetic method of choice, and could be achieved with a morphine-nitrous oxide relaxant anesthesia.