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A retrospective examination of regional plus general anesthesia in children undergoing open heart surgery
1Department of Anesthesia, Stanford University Medical Center, Stanford, CA 94305-5115, USA. ham@leland.stanford.edu
Insights
Regional anesthesia, including spinal anesthesia (SAB) and epidural anesthesia (EPID), combined with general anesthesia for pediatric cardiac surgery shows similar outcomes. Epidural anesthesia may reduce the need for postoperative sedatives and analgesics compared to spinal anesthesia.
Area of Science:
- Pediatric Anesthesiology
- Cardiac Surgery Anesthesia
- Regional Anesthesia Techniques
Background:
- Regional anesthesia combined with general anesthesia is increasingly used in pediatric cardiac surgery.
- Potential benefits include improved outcomes and reduced costs due to decreased mechanical ventilation needs.
Purpose of the Study:
- To evaluate the association of spinal anesthesia (SAB) or epidural anesthesia (EPID) with general anesthesia in pediatric cardiac surgery.
- Key outcomes assessed were circulatory stability, postoperative sedation/analgesia, and adverse effects.
Main Methods:
- Retrospective chart review of 50 children undergoing open heart surgery.
- Comparison between SAB and EPID groups combined with general anesthesia between September 1996 and December 1997.
Main Results:
- No significant differences were observed in vital sign changes, oxygen desaturation, hypercarbia, or vomiting between SAB and EPID groups.
- Patients receiving SAB required significantly more sedative and analgesic interventions postoperatively compared to the EPID group.
Conclusions:
- Both SAB and EPID, when combined with general anesthesia for pediatric cardiac surgery, appear to be associated with similar hemodynamic stability and adverse event profiles.
- Epidural anesthesia may offer an advantage in reducing the need for postoperative sedative and analgesic interventions.
Abstract:
The use of regional anesthesia in combination with general anesthesia for children undergoing cardiac surgery is receiving increasing attention from clinicians. The addition of regional anesthesia may improve clinical outcomes and decrease costs as a result of the reduced need for postoperative mechanical ventilation. The goal of this retrospective chart review was to evaluate whether spinal anesthesia (SAB) or epidural anesthesia (EPID) in combination with general anesthesia was associated with circulatory stability, satisfactory postoperative sedation/analgesia, and a low incidence of adverse effects. The medical records of 50 consecutive children having open heart surgery with SAB or EPID and general anesthesia between September 1996 and December 1997 were reviewed. We found no significant differences in the incidence of clinically significant changes in vital signs, oxygen desaturation, hypercarbia, or vomiting. Patients in the SAB group received significantly more sedative/analgesic interventions than those in the EPID group.