Sugammadex Use in a Patient with Wolff-Parkinson-White (WPW) Syndrome

Sugammadex Use in a Patient with Wolff-Parkinson-White (WPW) Syndrome

Background: Wolff-Parkinson-White (WPW) syndrome is a disease associated with episodes of supraventricular tachycardia and ventricular pre-excitation or atrial fibrillation. WPW is characterized by an aberrant electrical conduction pathway between atria and ventricles. Case Report: The major anesthetic problem connected with WPW syndrome is the risk of tachyarrhythmias due to accessory pathway. Therefore, it has been proposed that the aim of anesthetic management should be the avoidance of tachyarrhythmia and sympathetic stimulation. Sugammadex was administered as a neuromuscular reversal agent in this case. To our knowledge, this is the first case report of sugammadex use in a patient with WPW. This report presents a case of general anesthesia management in a patient with WPW syndrome. Conclusion: We think that it is appropriate to use sugammadex to reverse rocuronium for the prevention of sudden hemodynamic changes in patients with WPW who underwent general anesthesia.

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  • 1. Kabade SD, Sheikh S, Periyadka B. Anaesthetic management of a case of Wolff-Parkinson-White syndrome. Indian J Anaesth 2011;55:381-3. [CrossRef]
  • 2. Rahul S, Patel R, Dewoolkar. Anaesthetic management of WPW Syndrome. Internet J of Anaesthesiology 2006;11:2.
  • 3. Hines RL, Marschall KE. Abnormalities of Cardiac Conduction and Cardiac Rhythm. In: Stoelting RK, Dierdorf SF, editors. Anesthesia and co-existing disease. 5th ed. Philadelphia: ChurchillLivingstone; 2008:pp.72-3.
  • 4. Chhabra A., Trikha A., Sharma N. Unmasking of benign WPW syndrome under general anaesthesia. Indian J Anaesth 2003;47: 208-11.
  • 5. Sahu S, Karna ST, Karna A, Lata I, Kapoor D. Anaesthetic management of Wolff-Parkinson-White syndrome for hysterectomy. Indian J Anaesth 2011;55:378-80. [CrossRef]
  • 6. Okamoto T, Minami K, Shiraishi M, Ogata J, Shigematsu A. Repeated supraventricular tachycardia in an asymptomatic patient with Wolff-Parkinson-White syndrome during Cesarean delivery. Can J Anaesth 2003;50:752-3. [CrossRef]
  • 7. Dahl V, Pendeville PE, Hollmann MW, Heier T, Abels EA, Blobner M. Safety and efficacy of sugammadex for the reversal of rocuronium-induced neuromuscular blockade in cardiac patients undergoing noncardiac surgery. Eur J Anaesthesiol 2009;26:874- 84. [CrossRef]
  • 8. Hemmerling TM, Zaouter C, Geldner G, Nauheimer D. Sugammadex. A short review and clinical recommendations for the cardiac anesthesiologist. Ann Card Anaesth 2010;13:206-16. [CrossRef]
  • 9. de Kam PJ, Grobara P, Dennie J, Cammu G, Ramael S, JagtSmook ML, et al. Effect of sugammadex on QT/QTc interval prolongation when combined with QTc-prolonging sevoflurane or propofol anaesthesia. Clin Drug Investig 2013;33:545-51. [CrossRef]
  • 10. Osaka Y, Shimada N, SatouM, Masuda T, Ando T, Kozono Y, et al. A case of atrioventricular block (Wenckebach type) induced by sugammadex. J Anesth 2012;26:627-8.