Bradycardia with sevoflurane in siblings with branchio‐oto‐renal syndrome

MHG Taylor, NCT Wilton - Pediatric Anesthesia, 2007 - Wiley Online Library
MHG Taylor, NCT Wilton
Pediatric Anesthesia, 2007Wiley Online Library
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 …
Summary
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.
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