Successful pectoralis plane block for pacemaker implantation in brugada syndrome

Mohd Faeiz, Pauzi and Siti Norazlina, Juhari and Erham, Mat Hassan (2020) Successful pectoralis plane block for pacemaker implantation in brugada syndrome. In: The 97th Annual Scientific Meeting of the Korean Society of Anesthesiologists, 05-07 Nov 2020.

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Abstract

Effective anaesthesia and analgesia are vital components during pacemaker implantation surgery to maintain haemodynamic stability, especially in elderly and patients with compromised cardiac function. We report a case of successful pacemaker implantation surgery in a patient with Brugada Syndrome using monitored anaesthesia care utilizing unilateral pectoralis plane block. A single shot left side pectoralis plane block (PECS II) was done under ultrasound guidance. 5 ml of 0.5% Ropivacaine with 1% Lignocaine was injected between the fascial plane of pectoralis major and minor muscle, and 15 ml was injected in the fascial plane of pectoralis minor and serratus anterior muscle. The patient maintained a patent airway with oxygen supplementation via face mask, tolerating the procedure well, with no pain or restlessness and no significant haemodynamic changes. No sedation was required and patient did not require opioids post-operatively. He reported minimal pain for 24 h post-operatively (VAS ranging 0-2). PECS block can provide effective anaesthesia in high risk cardiovascular patients. This blocks can provide an opioid sparing option for post-operative management in pacemaker implantation surgery.

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