Anesthetic Management of a Patient With Wolff-Parkinson-White Syndrome Undergoing Gynecological Robotic Surgery.

anesthesiology eras myomectomy robotic surgery wpw syndrome

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
Jun 2024
Historique:
received: 16 04 2024
accepted: 20 06 2024
medline: 22 7 2024
pubmed: 22 7 2024
entrez: 22 7 2024
Statut: epublish

Résumé

Robotic surgery provides precision and safety for minimally invasive gynecological operations but introduces unique anesthetic challenges, especially for individuals with pre-existing conditions like Wolff-Parkinson-White (WPW) syndrome. This case report addresses the anesthetic management of a 32-year-old female with WPW syndrome undergoing a myomectomy. A thorough pre-operative evaluation, including an ECG, echocardiogram, and Holter monitoring, was performed to assess the anesthetic and cardiac risks. The patient was administered a combination of loco-regional and general anesthesia, with an emphasis on neuromuscular monitoring, antiarrhythmic preparedness, and pain management to effectively manage the complexities introduced by WPW syndrome and robotic surgery. The anesthetic protocol comprised premedication with midazolam, induction using sufentanil, propofol, and rocuronium, and maintenance with desflurane, along with techniques to mitigate the effects of pneumoperitoneum and Trendelenburg positioning. Employing these strategies, the surgery concluded successfully without any anesthetic or surgical complications. The patient experienced a rapid and complete awakening, achieved optimal pain control, and was able to mobilize early, leading to her discharge 24 hours post-surgery. This case demonstrates the essential nature of customized anesthetic management for patients with WPW syndrome undergoing robotic surgery. It underscores the necessity of an exhaustive pre-operative assessment, diligent intraoperative monitoring, and active postoperative care to ensure patient safety and promote swift recovery.

Identifiants

pubmed: 39036161
doi: 10.7759/cureus.62842
pmc: PMC11260423
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Pagination

e62842

Informations de copyright

Copyright © 2024, Ismail et al.

Déclaration de conflit d'intérêts

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Auteurs

Mohammed I Ismail (MI)

Anesthesiology, Mut'ah School of Medicine, Alkarak, JOR.

Omar R Al-Gharaibeh (OR)

Anesthesiology, Istishari Hospital, Amman, JOR.

Lana Talafha (L)

Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid, JOR.

Domenico Gammaldi (D)

Anesthesiology, Casa di Cura Tortorella, Salerno, ITA.

Giustino Varrassi (G)

Pain Medicine, Paolo Procacci Foundation, Rome, ITA.

Giovanna Grasso (G)

Anesthesiology, Azienda Ospedaliera Universitaria (AOU) Federico II, Napoli, ITA.

Classifications MeSH