Brugada syndrome (BS) is an inherited autosomal dominant ion channelopathy that increases the risk of ventricular tachycardia, ventricular fibrillation, and sudden cardiac death. It has an incidence of one to five per 10,000 people in Europe to as high as 20 per 10,000 people in Southeast Asia [1]. Channelopathies were highlighted as one of the most common causes of maternal mortality from heart disease in pregnancy in the 2016 Mother and Babies: Reducing Risks through Audits and Confidential Enquiries in United Kingdom report. Physiological stress observed in labor, fever, exaggerated vagal tone, electrolyte disturbances, and sodium channel blockers can precipitate malignant ventricular arrhythmias in BS. Remifentanil patient-controlled analgesia (Remi PCA) is a well-established, feasible alternative to labor epidural analgesia [2]. We present the safe and successful use of intravenous (IV) Remi PCA for labor in a parturient with BS.
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