Effects of General Anesthesia on the Results of Cardiac Catheterization in Pediatric Patients with Ventricular Septal Defect

Abstract

<b>Background:</b> There is no gold standard sedation method for pediatric cardiac catheterization. In congenital heart diseases with intracardiac shunts, hemodynamic parameters are prone to change depending on the ventilation conditions and anesthetics, although few studies have examined these effects. The purpose of this study was to investigate the effects of two different sedation methods on the hemodynamic parameters. <b>Methods:</b> This study retrospectively evaluated consecutive patients with ventricular septal defect (VSD) below 1 year of age who underwent cardiac catheterization at Aichi Children’s Health and Medical Center, who were divided into age- and VSD diameter-matched general anesthesia (GA) and monitored anesthesia care (MAC) under the natural airway groups (<i></i>n = 40 each), for comparison of hemodynamic parameters. <b>Results:</b> In the GA group, arterial blood pH and arterial partial pressure of oxygen were significantly higher (<i>p</i> < 0.01), whereas arterial partial pressure of carbon dioxide was significantly lower than in the MAC group (<i>p</i> < 0.01). Mean pulmonary artery pressure (<i>p</i> < 0.05) and systemic blood pressure (<i>p</i> < 0.01) were lower in the GA group. Pulmonary vascular resistance index (<i>p</i> < 0.01) and systemic vascular resistance index (<i>p</i> < 0.01) were also significantly lower in the GA group than the MAC group. There were no significant differences in pulmonary blood flow index, systemic blood flow index, and pulmonary/systemic blood flow ratio between the two groups. <b>Conclusions:</b> Cardiac catheterization under GA in VSD patients results in different hemodynamic parameters compared to that under MAC. In particular, when using pulmonary artery pressure and pulmonary vascular resistance measured under GA for judgment regarding the surgical indications or perioperative management, consideration should be given to the fact that these parameters might be lower compared to those measured under MAC.