Congenital heart disease is the most common birth defect which may be a part of a broader syndrome. Such patients pose many challenges when subjected to anaesthesia for non-cardiac surgery. Therefore, specific peri-operative management plan needs to be employed to reduce peri-operative morbidity.
We conducted 10 pediatric cases with congenital heart disease posted for cochlear implant surgery. The study was conducted in GMERS Medical College, Gandhinagar.
Each case was managed peri-operatively with standardized protocol. All patients had acyanotic congenital heart disease. 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 patient had any adverse cardiac event peri-operatively. Thus we were able to manage each patient successfully without any untoward consequences.
Key words: Congenital heart disease, cochlear implant, general anaesthesia, Ventricular septal defect, Etomidate, Pulmonary hypertension, Pulmonary vascular resistance, Systemic vascular resistance.
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