Related Experiment Video
Updated: Jul 12, 2025
Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery
Published on: June 2, 2022
Intensive Care Unit Analgosedation After Cardiac Surgery in Children with Williams Syndrome : a Matched Case-Control
Marcos Mills1, Claudia Algaze2, Chloe Journel2
1Division of Pediatric Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, 2835 Brandywine Road, Suite 400, 30341, Atlanta, GA, Georgia. mfmill6@emory.edu.
Insights
Patients with Williams syndrome (WS) undergoing cardiac surgery required similar postoperative analgosedative medication doses as controls. There were no significant differences in major adverse cardiac events or mortality, warranting further investigation into pain and sedation management in this population.
Area of Science:
- Cardiology
- Pediatric Critical Care
- Pharmacology
Background:
- Williams syndrome (WS) is associated with cardiovascular abnormalities requiring surgical intervention.
- Patients with WS have a unique neuropsychiatric profile that may increase perioperative risks.
- Postoperative analgosedative requirements in pediatric cardiac surgery patients with WS have not been extensively studied.
Purpose of the Study:
- To compare postoperative analgosedative requirements in patients with WS versus age-matched controls after cardiac surgery.
- To evaluate the frequency of major adverse cardiac events (ACE) and mortality in these groups.
Main Methods:
- A matched case-control study was conducted in a pediatric cardiac intensive care unit (CICU).
- Patients with WS and controls undergoing cardiac surgery between July 2014 and January 2021 were included.
- Total doses of morphine, midazolam, and dexmedetomidine equivalents were collected for the first six postoperative days.
Main Results:
- No significant differences were observed in the total doses of morphine equivalents, midazolam equivalents, or dexmedetomidine between the WS group and controls.
- The frequency of major ACE, including cardiac arrest, ECMO, and surgical re-intervention, was similar between the groups.
- Mortality rates did not differ significantly between patients with WS and the control group.
Conclusions:
- Patients with WS undergoing cardiac surgery received comparable analgosedative medication doses to controls.
- No significant differences in major ACE or mortality were found, but these results should be interpreted cautiously.
- Further research is needed to understand pain/sedation adequacy and influencing factors in WS patients post-cardiac surgery.
Objective:
Cardiovascular abnormalities are common in patients with Williams syndrome and frequently require surgical intervention necessitating analgesia and sedation in a population with a unique neuropsychiatric profile, potentially increasing the risk of adverse cardiac events during the perioperative period. Despite this risk, the overall postoperative analgosedative requirements in patients with WS in the cardiac intensive care unit have not yet been investigated. Our primary aim was to examine the analgosedative requirement in patients with WS after cardiac surgery compared to a control group. Our secondary aim was to compare the frequency of major ACE and mortality between the two groups.
Design:
Matched case-control study.
Setting:
Pediatric CICU at a Tertiary Children's Hospital.
Patients:
Patients with WS and age-matched controls who underwent cardiac surgery and were admitted to the CICU after cardiac surgery between July 2014 and January 2021.
Interventions:
None.
Measurements And Main Results:
Postoperative outcomes and total doses of analgosedative medications were collected in the first six days after surgery for the study groups. Median age was 29.8 (12.4-70.8) months for WS and 23.5 (11.2-42.3) months for controls. Across all study intervals (48 h and first 6 postoperative days), there were no differences between groups in total doses of morphine equivalents (5.0 mg/kg vs 5.6 mg/kg, p = 0.7 and 8.2 mg/kg vs 10.0 mg/kg, p = 0.7), midazolam equivalents (1.8 mg/kg vs 1.5 mg/kg, p = 0.4 and 3.4 mg/kg vs 3.8 mg/kg, p = 0.4), or dexmedetomidine (20.5 mcg/kg vs 24.4 mcg/kg, p = 0.5 and 42.3 mcg/kg vs 39.1 mcg/kg, p = 0.3). There was no difference in frequency of major ACE or mortality.
Conclusions:
Patients with WS received similar analgosedative medication doses compared with controls. There was no significant difference in the frequency of major ACE (including cardiac arrest, extracorporeal membrane oxygenation, and surgical re-intervention) or mortality between the two groups, though these findings must be interpreted with caution. Further investigation is necessary to elucidate the adequacy of pain/sedation control, factors that might affect analgosedative needs in this unique population, and the impact on clinical outcomes.
More Related Videos
06:46Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits
Published on: February 28, 2025
05:39Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Related Concept Videos
01:24Parenteral Anesthetics: Overview
01:24General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:22Stages of General Anesthesia
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...