Bradycardia with sevoflurane in siblings with Branchio-oto-renal syndrome

Paediatr Anaesth. 2007 Jan;17(1):80-3. doi: 10.1111/j.1460-9592.2006.02024.x.

Abstract

Branchio-oto-renal syndrome (BOR, Melnick-Fraser syndrome, MIM#113650) refers to a rare autosomal dominant disorder characterized by branchial cysts or fistulas, hearing loss, external ear malformation, preauricular pits and renal abnormalities. The authors present three episodes of significant bradycardia in two siblings diagnosed with BOR syndrome during the sevoflurane general anesthesia. There is no published experience of anesthesia with this syndrome. Bradycardia occurred variously at induction, maintenance and immediately prior to emergence and required surgical stimulation, atropine, or epinephrine to treat. We seek to raise awareness of the potential for bradycardia during the procedures in patients with this syndrome requiring volatile anesthesia, especially sevoflurane.

Publication types

  • Case Reports

MeSH terms

  • Anesthesia, General / adverse effects
  • Anesthetics, Inhalation / adverse effects*
  • Anti-Arrhythmia Agents / administration & dosage
  • Atropine / administration & dosage
  • Bradycardia / chemically induced*
  • Bradycardia / therapy
  • Branchio-Oto-Renal Syndrome / surgery*
  • Bronchodilator Agents / administration & dosage
  • Child
  • Child, Preschool
  • Electrocardiography / methods
  • Epinephrine / administration & dosage
  • Female
  • Heart Rate / drug effects
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Methyl Ethers / adverse effects*
  • Middle Ear Ventilation / methods
  • Monitoring, Physiologic / methods
  • Oxygen
  • Sevoflurane
  • Siblings*

Substances

  • Anesthetics, Inhalation
  • Anti-Arrhythmia Agents
  • Bronchodilator Agents
  • Methyl Ethers
  • Sevoflurane
  • Atropine
  • Oxygen
  • Epinephrine