• Mélanie Duque, Luís Santos, Sandy Ribeiro, and Dora Catré.
• Anesthesiology Department, Centro Hospitalar Tondela-Viseu, Avenida Rei D. Duarte, 3504 509, Viseu, Portugal. Electronic address: melanieduque@gmail.com.
• J Clin Anesth. 2017 Feb 1; 36: 168-173.

Study ObjectiveThe aim of this 12-year case series was to review the drugs used during anesthetic management of patients with diagnosis of or risk criteria for Brugada syndrome (BrS), and to document any possible association between these drugs and arrhythmogenic activity or unexplained hemodynamic instability.DesignA retrospective clinical observational study.SettingTertiary hospital.PatientsThirty-one patients met our inclusion criteria: 20 belonging to group D (diagnosed BrS) and 11 to group R (risk of BrS). They underwent a total of 43 anesthetic interventions (28 in group D and 15 in group R).InterventionsRecords from patients with or at risk of BrS who underwent anesthetic intervention at our hospital between May 2003 and May 2015 were retrospectively reviewed. Drugs used were compared with those recommended to be avoided or preferably avoided, published by specialists in the field at brugadadrugs.org.MeasurementsHemodynamic and cardiac complications during anesthesia were assessed for hypothetical association with these drugs.Main ResultsFrom the list of drugs available in medical literature recommended to avoid in BrS patients the following were used in our series: propofol (n = 8 in group D, n = 8 in group R), local anesthetics (n = 15 in group D, n = 8 in group R), tramadol (n = 1 in group D), and metoclopramide (n = 1 in group D). Hemodynamic complications occurred in 5 procedures, but no direct association was found between these events and the use of the drugs listed above.ConclusionsMajor adverse events related to the deleterious effects of drugs recommended to be avoided were not detected in our series of patients with or at risk of BrS. Although authors cannot refute the theoretical risk of major adverse advents when using known or potential BrS triggers, the true clinical risk of these drugs is unknown, and recommendations to avoid their use should be better supported.Copyright © 2016 Elsevier Inc. All rights reserved.

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