[High epidural anesthesia as a component of anesthetic support for cardiosurgical interventions in infants]

Area of Science:

• Pediatric Cardiac Surgery
• Anesthesiology
• Critical Care Medicine

Background:

• Ventricular septal defect (VSD) is a common congenital heart defect requiring surgical correction.
• Anesthetic management for infant cardiac surgery aims to optimize hemodynamics and reduce stress response.
• Epidural anesthesia is increasingly explored as an adjunct in pediatric surgical procedures.

Purpose of the Study:

• To evaluate the efficacy and safety of incorporating epidural anesthesia into the anesthetic regimen for infant VSD repair.
• To compare outcomes between infants receiving standard total intravenous anesthesia and those with augmented epidural anesthesia.

Main Methods:

• Prospective, nonrandomized, monocenter case-control study involving 79 infants undergoing VSD repair.
• Control group (n=41): Total intravenous anesthesia with propofol and fentanyl.
• Study group (n=38): Anesthesia potentiated by high, prolonged epidural anesthesia.

Main Results:

• The study group demonstrated decreased intraoperative anesthetic dosage compared to the control group.
• Patients receiving epidural anesthesia required shorter durations of inotropic support.
• A significant reduction in the duration of postoperative mechanical ventilation was observed in the study group.

Conclusions:

• Integrating epidural anesthesia into the anesthetic support for infant VSD surgery is expedient.
• Epidural anesthesia can lead to reduced anesthetic requirements and improved postoperative recovery, including shorter ventilation times.
• This anesthetic strategy may enhance outcomes for infants undergoing surgical correction of ventricular septal defects.