Abstract
ObjectiveTo compare the safety and efficacy of dexmedetomidine and remifentanil with sufentanil-based general anesthesia for the transthoracic device closure of ventricular septal defects (VSDs) in pediatric patients.MethodsA retrospective analysis was performed on 60 children undergoing the transthoracic device closure of VSDs from January 2019 to June 2020. The patients were divided into two groups based on different anesthesia strategies, including 30 cases in group R (dexmedetomidine- and remifentanil-based general anesthesia) and 30 cases in group S (sufentanil-based general anesthesia).ResultsThere was no significant difference in preoperative clinical information, hemodynamics before induction and after extubation, postoperative pain scores, or length of hospital stay between the two groups. However, the hemodynamic data of group R were significantly lower than those of group S at the time points of anesthesia induction, skin incision, thoracotomy, incision closure, and extubation. The amount of intravenous patient-controlled analgesia (PCA), the duration of mechanical ventilation, and the length of the intensive care unit (ICU) stay in group R were significantly less than those in group S.ConclusionDexmedetomidine combined with remifentanil-based general anesthesia for the transthoracic device closure of VSDs in pediatric patients is safe and effective.
Highlights
Ventricular septal defects (VSDs) are a common congenital heart disease
Yu et al Journal of Cardiothoracic Surgery (2021) 16:111 requirements for the cardiac anesthesia strategy come into play: choosing the appropriate anesthetic regimen for tracheal extubation as soon as possible, shortening the length of the intensive care unit (ICU) and hospital stay, and reducing the medical cost [3]
We reported our experience with the use of remifentanil-based general anesthesia for the transthoracic device closure of VSDs through small incisions under echocardiographic guidance [7]
Summary
Ventricular septal defects (VSDs) are a common congenital heart disease. Traditional surgical repair with cardiopulmonary bypass is associated with great trauma, aYu et al Journal of Cardiothoracic Surgery (2021) 16:111 requirements for the cardiac anesthesia strategy come into play: choosing the appropriate anesthetic regimen for tracheal extubation as soon as possible, shortening the length of the intensive care unit (ICU) and hospital stay, and reducing the medical cost [3]. Most studies have shown that fast-track cardiac anesthesia for children is feasible and safe, and many anesthesiologists have their own clinical experience in guiding the implementation of the corresponding anesthesia strategy in pediatric cardiac surgery [4,5,6]. We reported our experience with the use of remifentanil-based general anesthesia for the transthoracic device closure of VSDs through small incisions under echocardiographic guidance [7]. We tried to compare the safety and efficacy of another anesthesia strategy of dexmedetomidine and remifentanil with those of the strategy of sufentanil-based general anesthesia for the transthoracic device closure of VSDs in pediatric patients
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