Abstract
Introduction.
Experience of use of high thoracic epidural anesthesia (HTEA) in children with congenital
heart defect is limited. For explanation this problem HTEA was used in children with atrial septal defect
(ASD) at first. The aim of this research was efficiency and security estimation of use of HTEA in children
with ASD.
Material and methods.
In research were included 46 patients. In half of them (50%) was used HTEA as major
component of anesthesia (the main group — HTEA). In case of others was used multicomponent general
anesthesia based on narcotic analgesics (the control group — GANA).
Results.
Use of HTEA reduces anesthetic risk via decrease of dosage of narcotic analgesics and permits acti
vation of patients on the operation table. Despite extubation of children with HTEA on the operation table
in 43.5%, proportion of children, extubated within 6 h did not differ significantly in groups (HTEA — 82.6%,
GANA — 65.2%, р=0.18), as well as length of stay in ICU (within 12 h ICU discharge was 87% in group
HTEA and 73.9% in group GANA (р=0.26). Others were completely discharged during next 12 h (13% and
26.1% (р=0.26), respectively. Ratio of children with postoperative complications did not differ significantly
in groups (4.3 vs 17.4%, />=0.15).
Conclusion.
In spite of some advantages in compare with GANA, use of HTEA in children with ASD is not
pathophisiologicaly legitimated. This advantage does not exclude the risk of possible complications associ
ated with puncture and cateterization of the epidural spase.
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