Key result
A standardized peri-operative anesthetic protocol resulted in no adverse cardiac events among 10 pediatric patients with acyanotic congenital heart disease undergoing cochlear implant surgery.
Why the study?
Patients with congenital heart disease pose many challenges during anesthesia for non-cardiac surgery, requiring patient-specific peri-operative management to reduce morbidity.
Does a standardized anesthetic protocol prevent peri-operative adverse cardiac events in pediatric patients with acyanotic congenital heart disease undergoing cochlear implant surgery?
Case Series (n=10)
No
Does a standardized anesthetic protocol prevent peri-operative adverse cardiac events in pediatric patients with acyanotic congenital heart disease undergoing cochlear implant surgery?
A standardized anesthetic protocol using etomidate, atracurium, and lignocaine can be safely employed to prevent hemodynamic fluctuations and adverse cardiac events in pediatric patients with acyanotic congenital heart disease undergoing non-cardiac surgery.
May guide individualized perioperative plans for CHD children undergoing cochlear implant; leaves open need for larger prospective validation.
Congenital heart disease (CHD) is the most common birth defect which might be a part of a broader syndrome. Such patients pose many challenges when subjected to anesthesia for non-cardiac surgery. Therefore, a patient-specific peri-operative management plan needs to be employed to reduce peri-operative morbidity. We conducted 10 pediatric cases with CHD posted for cochlear implant surgery. The study was conducted in GMERS Medical College, Gandhinagar, India. Each case was managed peri-operatively with a standardized protocol. All patients had acyanotic CHD, and no patient had complex CHD. They were pre-operatively assessed in detail and optimized if required. As part of intra-operative management, care was taken to avoid sudden hemodynamic fluctuations by using etomidate as induction agent and atracurium as muscle relaxant. Inj. lignocaine was used to prevent hemodynamic response to intubation. Adequate analgesia was achieved. None of the patients had any adverse cardiac event peri-operatively. We were able to manage each patient successfully without any untoward consequences. Key words: Congenital heart disease; Cochlear implant; General anesthesia; Pulmonary hypertension; Pulmonary vascular resistance; Systemic vascular resistance Citation: Gadani HN, Jariwala ND, Kureshi MM, Shah VM, Thakkar PD. Anesthetic management of pediatric patients with congenital heart disease posted for cochlear implant: A case series. Anaesth. pain intensive care 2023;27(4):590−595; DOI: 10.35975/apic.v27i4.2272 Received: May 11, 2023; Reviewed: May 25, 2023; Accepted: Jun 07, 2023
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Gadani et al. (2023) conducted a case series in Congenital heart disease requiring cochlear implant (n=10). Standardized peri-operative anesthetic management was evaluated on Peri-operative adverse cardiac events. A standardized peri-operative anesthetic protocol resulted in no adverse cardiac events among 10 pediatric patients with acyanotic congenital heart disease undergoing cochlear implant surgery.
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