ANESTHETIC MANAGEMENT IN A PATIENT WITH TYPE 1 BRUGADA SYNDROME UNDERGOING INCISION AND DRAINAGE OF A NECK ABSCESS: A CASE REPORT

Abstract

Background: Brugada Syndrome is a rare inherited arrhythmia characterized by distinct ECG patterns and a risk of sudden cardiac death from ventricular arrhythmias. Anesthetic management is challenging due to the potential for perioperative triggers to precipitate malignant arrhythmias.

Case Presentation: A 27-year-old male with an anterior neck abscess was scheduled for incision and drainage under general anesthesia. Routine ECG revealed a Type 1 Brugada pattern, confirmed on repeated recordings and by cardiology consultation. A supraglottic airway (i-gel) was used to minimize intubation-related sympathetic stimulation. Anesthesia was maintained with spontaneous ventilation on a low-flow 50% oxygen–50% air mixture, avoiding volatile anesthetics and muscle relaxants. The procedure was uneventful except for a brief self-resolving episode of bradycardia. Postoperative cardiac monitoring in the ICU revealed no arrhythmias.

Conclusion: This case highlights the importance of meticulous preoperative planning, arrhythmia trigger avoidance, and vigilant perioperative monitoring in Brugada Syndrome patients. Supraglottic airway use can be a safe alternative to endotracheal intubation in select cases.