ObjectiveTo discuss the anesthetic procedure for left thoracic sympathectomy under thoracoscope for long QT syndrome patients. MethodsWe selected 8 patients with long QT syndrome classified American Society of Anesthesiologists Ⅱ-Ⅲ who were going to undergo left thoracic sympathectomy under thoracoscope between July 2011 and October 2014 as our study subjects. They were given a moderate amount of beta blockers before operation, inducted with 0.1 mg/kg midazolam, 3-6 μg/kg fentanyl, 2-4 mg/kg propofol, 0.3-0.6 mg/kg cis-atracurium, and maintained with propofol 1-4 mg/(kg·h) combined with 0.025-2.000 μg/(kg·min) fentanyl. We recorded the mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) and airway peak pressure, and end-tidal carbon dioxide before anesthesia induction (T0), at endotracheal intubation (T1), during artificial lung-collapse when surgery initiated (T2), 5 minutes after surgery initiation (T3), 15 minutes after surgery initiation (T4), during artificial lung-collapse at the end of surgery (T5) and during extubation (T6). ResultsWhen compared with T0, T2 got a higher MAP, T3 and T4 had a slower HR (P<0.05), but all were within a normal range. All the patients showed little change in airway peak pressure and end-tidal carbon dioxide during the surgery with no statistically significant difference (P>0.05). ConclusionProper anesthetic procedure for left thoracic sympathectomy under thoracoscope for long QT syndrome patients can reduce the incidence of perioperative malignant arrhythmia.