ABSTRACT : DISCUSS THE ANESTHETIC IMPLICATIONS

METHODS : SURGERY WAS DONE UNDER COMBINED SPINAL EPIDURAL

RESULTS : INTRA OPERATIVE BROAD COMPLEX TACHYCARDIA OCCURED . TREATED WITH VAGAL MANEUVER.

CONCLUSIONS : HIGH LIGHTS THE ANESTHETIC IMPLICATIONS IN THE MANAGEMENT OF THESE PATIENTS

CASE REPORT:

47 yrs old female, diagnosed with dysfunctional uterine Bleeding was posted for vaginal hysterectomy . She had palpitations and 2 episodes of syncope 7 yrs back, was investigated and was diagnosed as a case of wpw syndrome and started on Tab. amiodarone. She was asmptomatic at present.Preoperative assessment done with routine blood investigations, ecg ,echo and TFT. Cardiologist opinion obtained . Nil associatedvalvularabnormalites.Anesthetic management is to minimize stress response , maintain Haemodynamic stability, to avoid tachycardia. surgery was done under combined spinal epidural with 1.6 ml of bupivacaine heavy and 30 microg of fentanyl. Level adequate.Broad complex tacycardiaoccured which was managed with vagal manouvre and amiodarone. Postoperative period was uneventful.

CONCLUSION:

This case is presented to discuss the anesthetic implications of a patient with wpw syndrome , since even preexcitationaryythmias can result in sudden cardiac arrest due to ventricular fibrillation.