ABSTRACT : Sick sinus syndrome is a generalised abnormality of cardiac impulse formation that maybe caused either by an intrinsic disease of sinus node,which makes it unable to perform its pacemaking functioning or by extrinsic factors.Here we present the perioperative management of young female with sick sinus syndrome with appendicitis posted for appendicectomy

METHODS : 28 year old female scheduled for open appendicectomy.At the time of preanaestheticevaluation,P.R=54/min,B.P=90/50mmhg,ECG showed AV dissociation with bradyarrhythmia and normal ECHO.General anaesthesia was given under conventional monitoring.induction and relaxation agents used were thiopentone and vecuroniumrespectively.Patient reversed with neostigmine and atropine.

RESULTS : There was an episode of bradyarrhythmia which responded with single dose of atropine.the emergence from anaesthesia was uneventful.

CONCLUSIONS : Intraoperative arrhythmias are most common complications in practise of anaesthesia.knowledge of the arrhythmogenic mechanism of the drugs used routinely will enable the anaesthesiologist to make a correct diagnosis and provide relevant treatment to patients presenting this condition.

References- 1)Anaesthetic management of patient with sick sinus syndrome for exploratory laparotomy.Southafrican journal anesthesiologyanalg 2010;16(6):24-26
2)Intraoperative arrhythmias:Sick sinus syndrome manifested during general anesthesia.Rev. Columb.anestesiol. vol 39.no.2,apri/july2011