Sustained mitigation of ST-segment elevation in a patient with Brugada syndrome type 1 during sevoflurane and remifentanil anesthesia: a case report

During general anesthesia, patients with Brugada syndrome are at risk of malignant arrhythmias following worsened ST-segment elevation, potentially leading to sudden cardiac death. The protocol for safe anesthetic management of patients with Brugada syndrome has not yet been established. A 63-year-old man, diagnosed with a spontaneous Brugada type 1 pattern, was scheduled for a pleural biopsy using video-assisted thoracoscopic surgery under general anesthesia. We planned general anesthesia using volatile induction and maintenance anesthesia with sevoflurane and remifentanil. We monitored ST-segment morphology and observed sustained mitigation of ST-segment elevation throughout general anesthesia. The present case may indicate that safe anesthetic management of patients with Brugada syndrome depends on whether the anesthetics used can reduce ST-segment elevation.