1Department of Neurosurgery, Kings College Hospital, UK
2Clinical Neurophysiology, Neurophys Limited, UK
3Department of Anaesthetics, Kings College Hospital, UK
4,5School of Medicine, Kings College, UK
*Corresponding author:Chulananda Goonasekera, Consultant Anaesthetist, Department of Anaesthetics, Kings College Hospital NHS Trust, Denmark Hill, London SE5 9RS, UK
Submission: August 15, 2017;Published: December 13, 2017
ISSN 2640-9399 Volume1 Issue1
Wolff Parkinson White (WPW) syndrome associates with life-threatening tachy-arrhythmias. We report anesthetic management of a child with WPW syndrome requiring neurosurgery to resect3tumourdeposits (in cerebral hemisphere, cerebellum and spinal cord) under the guidance of intraoperative neuro-physiological monitoring (IONM). Our purpose of this case report is to elucidate the anesthetic limitations in facilitating multiple modes of neuro-monitoring whilst minimizing the risk of triggering an arrhythmia in a child with WPW syndrome. We conclude that multiple modes of IONM is safely possible with a tailor made, proportionately adjusted, inhalational and intravenous general anesthetic with particular attention to the cumulative doses of intravenous agents used.
Keywords: Pediatric, Anesthesia, Neuro-navigation, WPW syndrome
Abbreviations: WPW: Wolff Parkinson White Syndrome; IONM : Intra-Operative Neuro-Physiological Monitoring; EEG : Electro Encephalo Graphy; MEP : Motor Evoked Potential; SSEPs : Somatosensory Evoked Potentials; FR-EMG : Continuous Free Run Electromyo Graphy; CoMEPs : Corticobulbar Motor Evoked Potentials; GCS : Glasgow Coma Score; PSVT : Paroxysmal Supra Ventricular Tachycardia; AF : Atrial Fibrillation; TIVA : Total Intra-Venous Anesthesia