Propofol for Induction and Maintenance of Anesthesia in Patients With Brugada Syndrome: A Single-Center, 25-Year, Retrospective Cohort Analysis

BACKGROUND: Propofol administration in patients with Brugada syndrome (BrS) is still a matter of debate. Despite lacking evidence for its feared arrhythmogenicity, up to date, expert cardiologists recommend avoiding propofol. The main aim this study assess the occurrence malignant arrhythmias or defibrillations BrS, during and 30 days after propofol administration. secondary investigate adverse events hospitalization, as 30-day readmission mortality rate. METHODS: We performed retrospective cohort on BrS who received anytime from January 1, 1996 September 30, 2020. Anesthesia was induced by both groups. In total intravenous anesthesia (TIVA) group, maintained propofol, while BOLUS volatile provided. individual anesthetic charts full electronic medical records postprocedural were scrutinized. RESULTS: One hundred thirty-five underwent 304 procedures analyzed. TIVA group included 27 33 procedures, 108 271 procedures. median time infusion 60 minutes (interquartile range [IQR] = 30–180). estimated plasma effect-site concentration ranged between 1.0 6.0 µg·mL−1 target-controlled (TCI). rate manually driven varied 0.8 10.0 mg·kg−1·h−1. mean dose per kilogram body weight 2.4 ± 0.9 mg·kg−1. No registered 95% confidence interval (CI) risk groups 0-0.011 0-0.091, respectively. CONCLUSIONS: analysis patients, either bolus induction volatile-based anesthesia, revealed no defibrillations. present data do not support an increased propofol-based compared propofol-induced anesthesia. Prospective studies are needed electrophysiologic effects patents.