Abstract
Brugada Syndrome is an inherited disorder causing specific changes on
electrocardiogram (ECG) pattern of right bundle branch block and
persistent ST elevation in right precordial leads increases the risk of
cardiac arrest and fatal arrhythmia. Patients with brugada are prone to
abnormal cardiac rhythms which can be induced by alcohol, stress, vagal
stimulation, and certain medications. Thus medications are divided into
different classes from I to III with I carrying the most evidence for
potential arrhythmia while III being the least likely. Exceptional care
needs to be taken to avoid anesthetic and analgesic during surgeries for
such patients as several of the known anesthesia medications can lead to
arrhythmia in these patients. In this review we aimed to study the
effect different anesthetic and analgesic medication could have on
patients with brugada syndrome. We conducted a systematic review
following PRISMA guidelines to query PubMed, Embase, Cochrane library
and ProQuest electronic databases. Mesh combinations and synonyms of
“Brugada Syndrome”, “Anesthesia”, “Analgesics” were used. We
included all original human studies that focused on outcomes of
anesthetic and analgesics on patients with brugada. After screening 1149
studies, we included 49 articles consisting of a total of 1414 subjects
for qualitative analysis. We found local analgesics to be least likely
to lead to potential arrhythmic complications with other systemic and
inhaled agents having a risk although the risk varied because of
multitude of reasons ranging from type of drug to patient factors like
the patient’s condition and type of Brugada. We concluded that
anesthetic although could be used for individuals with Brugada the type
of anesthetic to be used should be selected keeping the potential
cardiac risk under consideration.