Anesthesia management in a patient who diagnosed with brugada syndrome in third preoperative evaluation

Brugada Syndrome (BS) is a rare genetic disease that can be fatal with malignant arrhythmias. It has been stated that drugs, which are frequently used in anesthesia practice, electrolytic or autonomic imbalance, fever, and infections can trigger cardiac arhythm and sudden cardiac death even in asymptomatic patients. Here we describe a patient who diagnosed with Brugada Syndrome in third preoperative evaluation. A 60-year-old male patient was scheduled for an infected knee prosthesis. The patient's preoperative laboratory findings were normal except for ECG changes. There was ST segment elevation in V1 and V2 leads in the ECG. The patient was consulted with the cardiology clinic and was evaluated as Brugada Syndrome ECG type 1. There is no consensus regarding the application and technique of anesthesia for these patients. We decided to apply general anesthesia because we could provide better hemodynamic stabilization. The patient was transferred to the intensive care unit. There were no adverse events observed during the anesthetic management and discharged from the hospital on the second postoperative day. 
We emphasize the importance of detailed preoperative evaluation each time, even in patients with a known anesthesia history.