Key result
Anaesthesia using thiopentone, atracurium, sevoflurane, and fentanyl allowed for the successful and haemodynamically stable implantation of temporary epicardial pacing wires in a 1.5-kg premature neonate with complete congenital heart block.
Case Report (n=1)
No
Prophylactic application of trimmed transcutaneous pacing pads and use of thiopentone induction provided safe anaesthetic management for a premature, low-birth-weight neonate undergoing epicardial pacing for congenital complete heart block.
Hypothesis-generating for anesthetic management in premature neonates with congenital heart block; larger studies required before practice change.
The optimal anaesthetic management of neonates with complete congenital heart block (CCHB) is unknown, as there is a low incidence of such cases. Neonates with CCHB often require surgery for the initiation of electronic pacing. In addition to the challenges of anaesthetising a neonate, this procedure is risky due to the potential for hypotension, arrhythmias and cardiac arrest. We herein present the case of a premature low-birth-weight neonate with antibody-related CCHB and normal heart structure who underwent anaesthesia and surgery for epicardial pacing wire insertion on Day 1 of life. We also compare our patient's anaesthetic conduct and outcome with similar previously reported cases.
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Ng et al. (2014) conducted a case report in Complete congenital heart block (n=1). Anaesthetic management and temporary epicardial pacing wire insertion was evaluated on Successful implantation of temporary epicardial pacing wires and haemodynamic stability. Anaesthesia using thiopentone, atracurium, sevoflurane, and fentanyl allowed for the successful and haemodynamically stable implantation of temporary epicardial pacing wires in a 1.5-kg premature neonate with complete congenital heart block.
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