General Endotracheal Anesthesia vs Total Intravenous Anesthesia for Children Undergoing Low-Risk Cardiac...

Area of Science:

• Pediatric Cardiology
• Anesthesiology
• Medical Technology

Background:

• Historically, general endotracheal anesthesia (GETA) was standard for pediatric cardiac catheterization.
• Current practice trends lean towards total intravenous anesthesia (TIVA) for these procedures.

Purpose of the Study:

• To compare procedural outcomes between GETA and TIVA in children undergoing low-risk cardiac catheterization.
• To evaluate the impact of anesthesia type on patient time and safety in the pediatric cardiac catheterization laboratory (PCCL).

Main Methods:

• Retrospective review of 401 patients (aged 1-12 years) undergoing outpatient diagnostic or simple interventional catheterization.
• Patients were stratified into GETA and TIVA cohorts.
• Primary outcome: total patient time in PCCL ('door-to-door' time). Secondary outcomes: procedure duration ('sheath time'), hospital stay, and major adverse event (MAE) rate.

Main Results:

• No significant differences were observed in demographic factors, procedure duration, hospital stay, or MAE rates between GETA and TIVA cohorts.
• The TIVA cohort demonstrated a significantly shorter average 'door-to-door' time (25 minutes less) compared to the GETA cohort (p < 0.001).

Conclusions:

• Total intravenous anesthesia (TIVA) is associated with reduced 'door-to-door' time in the pediatric cardiac catheterization laboratory for low-risk procedures.
• TIVA offers a potential clinical advantage by improving laboratory efficiency without increasing procedure duration, hospital stay, or complication rates.