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Developments in Anaesthetics & Pain Management

Multi-Modal Neuro-Monitoring and Anesthesia during Neurosurgery in a Child with Wolf-Parkinson-White Syndrome: A Case Report

Submission: August 15, 2017;Published: December 13, 2017

Volume1 Issue1
December , 2017


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

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