A Sufentanil-Based Rapid Cardiac Anesthesia Regimen in Children Undergoing Percutaneous Minimally-Invasive Intraoperative Device Closure of Ventricular Septal Defect.

Zeng-Chun Wang,Qiang Chen,Ling-Shan Yu,Gui-Can Zhang,Liang-Wan Chen

doi:10.21470/1678-9741-2019-0176

Abstract

ObjectiveTo assess the effectiveness and safety of fast-track cardiac anesthesia using the short-acting opioid sufentanil in children undergoing intraoperative device closure of ventricular septal defect (VSD).MethodsThis retrospective clinical study included 65 children who underwent intraoperative device closure of VSD between January 2017 and June 2017. Patients were diagnosed with isolated perimembranous VSD by transthoracic echocardiography. Then, they were divided into two groups, group F (n=30), whose patients were given sufentanil-based fast-track cardiac anesthesia, and group C (n=35), whose patients were given conventional cardiac anesthesia. Perioperative clinical data were analyzed.ResultsNo significant differences were found between the preoperative clinical parameters and intraoperative hemodynamic indices between the two groups. In group C, compared with group F, the postoperative duration of mechanical ventilation, the length of stay in the intensive care unit, the length of hospital stay, and the hospital costs were significantly increased.ConclusionIn this retrospective study at a single center, sufentanil-based fast-track cardiac anesthesia was shown to be a safe and effective technique for minimally-invasive intraoperative device closure of VSD in children, which was performed with reduced in-hospital costs.

Highlights

Ventricular septal defect (VSD) is a common type of congenital heart disease in children[1]
In group C, compared with group F, the postoperative duration of mechanical ventilation, the length of stay in the intensive care unit, the length of hospital stay, and the hospital costs were significantly increased. In this retrospective study at a single center, sufentanil-based fast-track cardiac anesthesia was shown to be a safe and effective technique for minimally-invasive intraoperative device closure of VSD in children, which was performed with reduced in-hospital costs
The fast-track anesthesia technique involves adjusting the use of anesthetic agents and modifying anesthetic techniques to achieve the appropriate depth of anesthesia, early recovery of postoperative spontaneous breathing, a shorter duration of mechanical ventilation, a shorter length of intensive care unit (ICU) stay, and a reduction in postoperative complications

Summary

Introduction

Ventricular septal defect (VSD) is a common type of congenital heart disease in children[1]. The standard surgical treatment for VSD includes surgical repair and percutaneous device closure. Minimally-invasive intraoperative device closure of VSD has become widely used and it has several advantages that include reduced trauma, minimally-invasive percutaneous delivery, use of echocardiography guidance, ease of operation and medical training, reduced procedure time, rapid postoperative recovery, low medical costs, and ease of conversion to conventional surgical repair in the event of device failure[2,3,4,5]. Fast-track cardiac anesthesia has previously been shown to be effective for adult cardiac surgical patients, resulting in rapid postoperative recovery[6,7].

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Conclusion