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Related Experiment Videos

[Anesthesia for pectus excavatum].

M Onodera1, S Fukuda, K Taga

  • 1Department of Anesthesiology, Niigata University School of Medicine.

Masui. the Japanese Journal of Anesthesiology
|December 1, 1990
PubMed
Summary
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Enflurane-nitrous oxide-oxygen anesthesia is safer for pectus excavatum surgery than halothane-nitrous oxide-oxygen, reducing arrhythmia risk. Close postoperative pulmonary monitoring is crucial for patients undergoing pectus excavatum repair.

Area of Science:

  • Cardiothoracic Surgery
  • Anesthesiology
  • Pediatric Surgery

Background:

  • Pectus excavatum is a congenital chest wall deformity requiring surgical correction.
  • The Ravitch operation is a common surgical approach for pectus excavatum.
  • Anesthetic choices can impact perioperative outcomes in thoracic surgery.

Purpose of the Study:

  • To compare the incidence of arrhythmia, postoperative complications, and pulmonary oxygenation (PaO2) between halothane-nitrous oxide-oxygen (GOF) and enflurane-nitrous oxide-oxygen (GOE) anesthesia during the Ravitch operation.
  • To evaluate the safety and efficacy of different anesthetic agents in pectus excavatum repair.

Main Methods:

  • A prospective study involving 48 patients undergoing the Ravitch operation for pectus excavatum.
  • Patients were randomized to receive either GOF or GOE anesthesia.

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  • Intraoperative anesthetic management and postoperative outcomes including ECG, chest X-ray, and PaO2 were monitored.

    • Main Results:

    • Preoperative ECG abnormalities were noted in 24% of patients (18 of 48), with incomplete right bundle branch block, left atrium enlargement, and sinus arrhythmia being most common.
    • Ventricular arrhythmia occurred in 33% of patients (4 of 12) under GOF anesthesia, versus none under GOE anesthesia.
    • Postoperative chest X-rays revealed pulmonary atelectasis (60%), pleural effusion (48%), and pneumothorax (8%).

    Conclusions:

    • GOE anesthesia is associated with a lower incidence of intraoperative ventricular arrhythmia compared to GOF anesthesia in patients undergoing the Ravitch operation.
    • Enflurane-based anesthesia may offer advantages over halothane-based anesthesia for pectus excavatum surgery.
    • Vigilant postoperative pulmonary surveillance is essential to manage potential complications following pectus excavatum repair.