4 ms·

Unfortunately, they have to use absolute minimal doses of locals as well, as they also increase cardiac arrythmias in Brugada patients, especially those of us w

Unfortunately, they have to use absolute minimal doses of locals as well, as they also increase cardiac arrythmias in Brugada patients, especially those of us with very distinct type I Brugada ECG patterns. It kinda sucks, but hey, despite many cardiac episodes (my first VF was at 14, and I'm 58 now) I'm still alive. And I'm a cyborg.

rscho 6y ago
I understand and I agree. Another thing you might try is hypnosis or autohypnosis. It works pretty well for that kind of thing. Besides, that would also allow the anesthesiologist to give you efficient painkillers and sedation that does not interact with sodium channels. However, I think you would find the cumulative dose of 3.5 h of intermittent lignocaine injections surprisingly high. And let me assure you that they have absolutely no idea of your true lignocaine plasma level. The comparative peak with long-lasting drugs will likely be much lower. All in all, I guess my main point is that if by chance you're doing that without an attending anesthesiologist you should try to ask for one and you might find it far more comfortable. You probably already know this, but: https://www.google.com/url?sa=t&source=web&rct=j&url=http://www.orpha.net/data/patho/Ans/en/Brugada_EN.pdf&ved=2ahUKEwiZoK6mgq3qAhVBs4sKHT7ND3kQFjABegQIAxAB&usg=AOvVaw0AJykZAmSc77mOGJ-ILKJk https://www.google.com/url?sa=t&source=web&rct=j&url=http://...
- Perenti 6y ago
  Yeah, I did know most of that. But a nice summary anyway. One big difference is that they monitor me with 7 (in the ward) and 12 (during surgery) lead ECG, not 5. Fortunately, being in Australia where there is universal health care, I have an excellent team working with me. Typically in the Cardiac Catheter Laboratory there's the Professor (surgeon), a cardiac aneathetist, several registrars and students, several nurses, a technician from Biotronik, and a cardiac scientist. They use absolutely minimal doses of lignocaine, based on my reporting pain levels during surgery. They do give me a very small dose of propofol during the test at the end, when they induce VF and AF to test the unit. I'm told this is much less stressful than being awake while fibrilating and being shocked (twice). I know that going into VF and AF feels bloody aweful, and syncope often results in nasty falls, so being knocked out for that makes sense. I did break my arm once when shocked though - those stainless steel tables are bloody hard! I know a patient in the US who had a bill for $145k after getting his ICD. I on the other hand pay nothing, except a lifetime of higher taxes than Americans pay.

rscho 6y ago

I understand and I agree. Another thing you might try is hypnosis or autohypnosis. It works pretty well for that kind of thing. Besides, that would also allow the anesthesiologist to give you efficient painkillers and sedation that does not interact with sodium channels. However, I think you would find the cumulative dose of 3.5 h of intermittent lignocaine injections surprisingly high. And let me assure you that they have absolutely no idea of your true lignocaine plasma level. The comparative peak with long-lasting drugs will likely be much lower. All in all, I guess my main point is that if by chance you're doing that without an attending anesthesiologist you should try to ask for one and you might find it far more comfortable. You probably already know this, but: https://www.google.com/url?sa=t&source=web&rct=j&url=http://www.orpha.net/data/patho/Ans/en/Brugada_EN.pdf&ved=2ahUKEwiZoK6mgq3qAhVBs4sKHT7ND3kQFjABegQIAxAB&usg=AOvVaw0AJykZAmSc77mOGJ-ILKJk https://www.google.com/url?sa=t&source=web&rct=j&url=http://...

Perenti 6y ago
Yeah, I did know most of that. But a nice summary anyway. One big difference is that they monitor me with 7 (in the ward) and 12 (during surgery) lead ECG, not 5. Fortunately, being in Australia where there is universal health care, I have an excellent team working with me. Typically in the Cardiac Catheter Laboratory there's the Professor (surgeon), a cardiac aneathetist, several registrars and students, several nurses, a technician from Biotronik, and a cardiac scientist. They use absolutely minimal doses of lignocaine, based on my reporting pain levels during surgery. They do give me a very small dose of propofol during the test at the end, when they induce VF and AF to test the unit. I'm told this is much less stressful than being awake while fibrilating and being shocked (twice). I know that going into VF and AF feels bloody aweful, and syncope often results in nasty falls, so being knocked out for that makes sense. I did break my arm once when shocked though - those stainless steel tables are bloody hard! I know a patient in the US who had a bill for $145k after getting his ICD. I on the other hand pay nothing, except a lifetime of higher taxes than Americans pay.