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[Reasonable anesthetic management for correction of Ebstein's anomaly]
Pei-rong Lin1, Xiu-shu Luan, Dong-ya Zhang
1Department of Anesthesiology, First Hospital of Tsinghua University, Beijing 100016, China. lalunalin@163.com
Objective:
To summarize the experience in anesthetic management for correction of Ebstein's anomaly.
Methods:
A total of 79 patients with Ebstein's anomaly who underwent surgical repair in our hospital during the time from March 2004 to September 2010 were retrospectively summarized for their anesthetic management. Anesthesia was done for the patients undergoing correction of Ebstein's anomaly. The adults patients were premedicated with intramuscular morphine 0.2 mg/kg and diazepam 0.05 mg/kg. The children patients were premedicated with intramuscular ketamine 5 - 8 mg/kg and atropine 0.05 - 0.20 mg. General anesthesia was induced with midazolam 0.1 - 0.2 mg/kg, etomidate 0.2 - 0.3 mg/kg, sulfentanil 1.0 - 1.5 µg/kg, pipecuronium or vecuronium 0.1 - 0.2 mg/kg, and maintained with isoflurane inhalation and intermittent iv. midazolam and sulfentanil.
Results:
Anesthetic course was smooth. The symptom in all cases was improved significantly after operation. No patients died during perioperative period.
Conclusion:
The key points for the anesthetic management of Ebstein's anomaly include precise preoperative evaluation, steady hemodynamic, proper maintenance of suitable pulmonary vascular resistance and cardiac function.
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