[Anesthetic management using propofol and fentanyl of a patient with concealed Wolff-Parkinson-White syndrome].

We report the anesthetic management using propofol and fentanyl of a patient with concealed Wolff-Parkinson-White syndrome. A 62-year-old patient was diagnosed as having concealed Wolff-Parkinson-White syndrome by electrophysiologic study 7 years before. He felt palpitation in spite of administration of disopiramide. He was scheduled for a microsurgery of the larynx. After premedication with atropine 0.5 mg and hydroxyzine 50 mg i.m. 30 min prior to anesthesia, anesthesia was induced with a step down method of propofol (20-->12-->8 mg.kg-1.h-1) and fentanyl 0.15 mg Anesthesia was maintained with 6 to 8 mg.kg-1.h-1 of propofol and periodic administration of fentanyl. Immediately after the insertion of a laryngoscope, blood pressure increased but systolic blood pressure was maintained from 120 to 140 mmHg during the procedure. Thereafter anesthesia remained stable and paroxysmal tachycardia did not appear. The postoperative course was uneventful. We conclude that anesthesia using propofol and fentanyl is useful in a patient with Wolff-Parkinson-White syndrome in order to prevent paroxysmal tachycardia.