Background: Brugada syndrome is a rare genetic autosomal dominant disease which affects ion channels of the cardiac conduction system and causes a coved ST segment elevation in the right precordial leads. Patients af icted with this disease can develop malignant ventricular arrhythmias and increased risk of sudden cardiac death (SCD). It prevalence higher in Asian and Southeast Asia countries, is much more prevalent in men than in women.

Case: 56 years old man, 72 kg, 168 cm. With adenocarcinoma sigmoid, hepar metastase and Brugada syndrome type II, undergoing lower anterior resection. General anesthesia, premedicated with midazolam, and induced with propofol, fentanyl and atracurium and maintenace of anesthesia with sevo uran, oxygen and N2O. Reversal with neostigmin and atropine sulphate. Post operative analgesia with morphine via epidural cathether and paracetamol intravena. theres no developed a malignant rhythm during induction and maintenance of anesthesia.

Summary: It is important to keep the patient from exposure to medications or other factors that can trigger malignant arrhythmias and can perform good and proper management in case of complications during the perioperative period.

Pendahuluan: Sindrom Brugada suatu kelainan genetika autosomal dominan yang jarang, dimana kelainannya terletak pada saluran ion natrium di sistem konduksi jantung yang manifestasinya berupa kelainan pada gambaran EKG di sadapan prekordial jantung, pasien – pasien dengan kelainan ini beresiko tinggi mengalami aritmia ventrikular maligna dan kematian tiba – tiba. Prevalensi tertinggi di negara – negara Asia dan Asia Tenggara. insiden pada laki – laki lebih tinggi dibandingkan dengan perempuan..

Kasus: Seorang laki – laki, 56 tahun, 72 kg, 168 cm. Di diagnosa dengan adenokarsinoma sigmoid, metastase hepar dan sindrom Brugada tipe II. Menjalani pembedahan lower anterior resection. Dilakukan anestesi umum, premedikasi dengan midazolam, induksi anestesi dengan propofol, fentanyl dan atrakurium. Rumatan anestesia menggunakan sevo uran, oksigen dan N2O. Reversal dengan neostigmin dan sulfas atropin Analgetika pasca bedah menggunakan mor n melalui epidural dan paracetamol intravena. Selama masa intra operatif tidak terjadi perubahan gambaran ekg yang mengancam nyawa pasien.

Ringkasan: Penting untuk menjaga pasien agar tidak terpapar dengan obat – obatan atau faktor – faktor lain yang dapat memicu terjadinya aritmia maligna serta dapat melakukan pengelolaan yang baik dan tepat bila terjadi komplikasi selama masa perioperatif.

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