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2005, Number 6

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Rev Mex Pediatr 2005; 72 (6)

Anesthesial management in the transcatheter closure of atrial septal defects in children

Fuentes-García V, Gerardo-de la Cruz S, Alarcón-Almanza JM, Moyao-García D, Nava-Ocampo AA

Language: Spanish
References: 35
Page: 292-297
PDF size: 175.63 Kb.


ABSTRACT

Objective. To report the experience obtained in the anesthetic management during the transcatheter closure of inter-auricular communication (IAC) by means of the Amplatzer atrial septal occluder.
Patients and methods. The observations were done in five children of 7 to 15 years age. Previous to the insertion of a transesophagic echocardiography transducer, inhalatory administration of sevoflurane and intravenous administration of midazolam/nalbuphine were performed. During the catheterization, sevoflurane was administered for anesthetic maintenance through the laryngeal mask.
Results. In all patients, laryngeal mask and transducer were successfully inserted without any complication, induction was administered with sevoflurane by facial mask and intravenous administration of midazolam/nalbufina. At the time of occlusion of atrial intercommunication, one child had bradychardia (62 beats per min) that improved with higher fluxes of 100% O2. Anesthetic emersion occurred in 5 to 10 mm after discontinuation of sevoflurane. In all patients, echocardiographic transducer and laryngeal mask were removed without any complication.
Conclusion. In despite that the experience was limited to five cases, laryngeal mask seems to be a good alternative to endotracheal tube for closure of inter-auricular communications with the Amplatzer device in pediatric patients.


REFERENCES

  1. Arévalo-Salas LA, Segura-Stanford B, Espinosa-Islas G, Reyes-de la Cruz L, Vizcaíno-Alarcón A. Un procedimiento seguro y eficaz para el cierre de la comunicación interatrial sin cirugía. Experiencia preliminar. Bol Med Hosp Infant Mex 2004; 61: 180-7.

  2. Baum VC, Palmisano BW. The immature heart and anesthesia. Anesthesiology 1997; 87: 1529-48.

  3. Shulman DL, Burrows FA, Poppe DJ, Smallhorn JS. Perioperative respiratory compliance in children undergoing repair of atrial septal defects. Can J Anaesth 1991; 38: 292-7.

  4. LeRoy S, Elixson EM, O’Brien P, Tong E, Turpin S, Uzark K. Recommendations for preparing children and adolescents for invasive cardiac procedures. A statement from the American Heart Association Pediatric Nursing Subcommittee of the Council on Cardiovascular Diseases of the Young. Circulation 2003; 108: 2550-64.

  5. Uzark K. Therapeutic cardiac catheterization for congenital heart disease-a new era in pediatric care. J Pediatr Nurs 2001; 16: 300-7.

  6. Sideris EB, Sideris SE, Fowlkes JP, Ehly RL, Smith JE, Gulde RE. Transvenous atrial septal defect occlusion in piglets with a “buttoned” double-disk device. Circulation 1990; 81: 312-8.

  7. Zavala AJI, García E, Zunzunegui MJL, Maroto AE, Maroto MC, Greco R et al. Cierre percutáneo de la comunicación interauricular: resultados a medio plazo de esta nueva opción terapéutica. Rev Esp Cardiol 2000; 53: 21-6.

  8. Fernández RA, del Cerro MMJ, Rubio VD, Castro GMC, Moreno GF. Cierre percutáneo de la comunicación interauricular mediante dispositivo Amplatzer: resultado inicial y seguimiento a mediano plazo. Rev Esp Cardiol 2001; 54: 1190-6.

  9. Hickey PR, Wessel DL, Streitz SL, Fox ML, Kern FH, Bridges ND et al. Transcatheter closure of atrial septal defects: hemodynamic complications and anesthesic management. Anesth Analg 1992; 74: 44-50.

  10. Laussen PC, Hansen DD, Perry SB, Fox ML. Javorski JJ, Burrows FA et al. Transcatheter closure of ventricular septal defects: hemodynamic instability and anesthetic management. Anesth Analg 1995; 80: 1076-82.

  11. Bialkowski J, Kusa J, Szkutnik M, Kalarus Z, Banaszak P, Bermudes-Cañete R et al. Cierre percutáneo de la comunicación interauricular. Resultado a corto y mediano plazo. Rev Esp Cardiol 2003; 56: 383-8.

  12. Lock JE, Rome JJ, Davis R, Van Praagh S, Perry SB, Van Praagh R et al. Transcatheter closure of atrial septal defects. Experimental studies. Circulation 1989; 79: 1091-9.

  13. Sharafuddin MJA, Gu X, Titus JL, Urness M, Cervera-Ceballos JJ, Amplatz K. Transvenous closure of secundum atrial septal defects preliminary results with a new self-expanding nitinol prosthesis in a swine model. Circulation 1997; 95: 2162-8.

  14. Ende DJ, Chopra PS, Rao PS. Transcatheter closure of atrial septal defect or patent foramen ovale with the buttoned device for prevention of recurrent of paradoxic embolism. Am J Cardiol 1996; 78: 233-6.

  15. Hessling G, Hyca S, Brockmeier K, Ulmer HE. Cardiac dysrhythmias in pediatric patients before and 1 year after transcatheter closure of atrial septal defects using the Amplatzer septal occluder. Pediatr Cardiol 2003; 24: 259-62.

  16. Javorski JJ, Hansen DD, Lausen PC, Fox ML, Lavoie J, Burrows FA. Paediatric cardiac catheterization: innovations. Can J Anaesth 1995; 42: 310-29.

  17. Wodey E, Pladys P, Copin C, Lucas MM, Chaumont A, Carre P et al. Comparative hemodynamic depression of sevoflurane versus halothane in infants. An echocardiographic study. Anesthesiology 1997; 87: 795-800.

  18. Puchner W, Egger P, Pühringer F, Lökinger A, Obwegeser J, Gombotz H. Evaluation of remifentanil as single drug for awake fiberoptic intubation. Acta Anaesthesiol Scand 2002; 46: 350-4.

  19. Foubert L, Reyntjens K, De Wolf D, Suys B, Moerman A, Mortier E. Remifentanil infusion for cardiac catheterization in children with congenital heart disease. Acta Anaesthesiol Scand 2002; 46: 355-60.

  20. Russell IA, Miller HWC, Gregory G, Balea MC, Cassorla L, De Silva A et al. The safety and efficacy of sevoflurane anesthesia in infants and children with congenital heart disease. Anesth Analg 2001; 92: 1152-8.

  21. American Academy of Pediatrics Committee on Drugs. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures. Pediatrics 1992; 89: 1110-15.

  22. Parker RI, Mahan RA, Giugliano D, Parker MM. Efficacy and safety of intravenous midazolam and ketamine and sedation for therapeutic and diagnostic procedures in children. Pediatrics 1997; 99: 427-31.

  23. American Academy of Pediatrics Committee on Drugs and Committee on Environmental Health. Use of chloral hydrate for sedation in children. Pediatrics 1993; 92: 471-3.

  24. McCann ME, Kain ZN. The management of preoperative anxiety in children: An update. Anesth Analg 2001; 93: 98-105.

  25. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 1996; 84: 459-71.

  26. Lebovic S, Reich DL, Steinberg LG, Vela FP, Silvay G. Comparison of propofol versus ketamine for anesthesia in pediatric patients undergoing cardiac catheterization. Anesth Analg 1992; 74: 490-4.

  27. Salvi L, Pepi M. Pressure-assisted breathing through a laryngeal mask airway during transesophageal echocardiography. Anesth Analg 1999; 89: 1591.

  28. Matsuzaki M, Toma Y, Kusukawa R. Clinical applications of transesophageal echocardiography. Circulation 1990; 82: 709-22.

  29. Hellebrand WE, Fahey JT, McGowan FX, Welting GG, Kleinman CS. Transesophageal echocardiographic guidance of transcatheter closure of atrial septal defect. Am J Cardiol 1990; 66: 207-13.

  30. Burrows FA, Taylor RH, Hillier SC. Early extubation of the trachea after repair of secundum-type atrial septal defects in children. Can J Anesth 1992; 39: 1041-4.

  31. Lin SM, Tai SK, Wang JK, Han YY, Jean W, Yeh YC. Supplementing transesophageal echocardiography with transthoracic echocardiography for monitoring transcatheter closure of atrial septal defects with attenuated anterior rim: a case series. Anesth Analg 2003; 96: 1584-8.

  32. Weigner MB, Herndon OW, Gaba DM. The effect on electronic record keeping and transesophageal echocardiography on task distribution, workload, and vigilance during cardiac anesthesia. Anesthesiology 1997; 87: 144-55.

  33. American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Practice guidelines for perioperative transesophageal echocardiography. Anesthesiology 1996; 84: 986-1006.

  34. Muhiudeen RIA, Miller-Flanee WC, Silverman NR. Intraoperative transesophageal echocardiography for pediatric patients with congenital heart disease. Anesth Analg 1998; 87: 1058-76.

  35. Moyao-García D, Corrales-Fernández MA, Blanco-Rodríguez G, Sánchez-Hernández E, Nava-Ocampo AA. Benefits of oral administration of an electrolyte solution interrupting a prolonged preoperatory fasting period in pediatric patients. J Pediatr Surg 2001; 36: 457-9.




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