Comparison of Fast-Track and Conventional Anesthesia for Transthoracic Closure of Ventricular Septal Defects in Pediatric Patients

Abstract

Background: To compare and analyze the safety and efficacy of fast-track and conventional anesthesia for transthoracic closure of ventricular septal defects (VSDs) in pediatric patients. Methods: A total of 82 pediatric patients undergoing transthoracic closure of VSDs between September and December 2017 were retrospectively analyzed. The patients were divided into two groups, including 42 patients in group F (fast-track anesthesia) and 40 patients in group C (conventional anesthesia). The perioperative clinical data of both groups were collected and statistically analyzed. Results: There were no fatal complications in both groups. No complete atrioventricular block (AVB), new aortic valve regurgitation, and device closure failure were observed. No significant difference was found in preoperative general data or intraoperative hemodynamic changes between the two groups (P >0.05). However, the mechanical ventilation time, length of postoperative intensive care unit (ICU) stay, length of hospital stay, and hospitalization expenses of group F were significantly lower than those of group C (P <0.05). Conclusion: It is safe and effective to use fast-track anesthesia for transthoracic closure of VSDs in pediatric patients.

Sufentanil Reduces Emergence Delirium in Children Undergoing Transthoracic Device Closure of VSD After Sevoflurane-Based Cardiac Anesthesia

“…Our cardiac center reported a larger series of cases from our experience with this technique [ 2 ] . Fast-track cardiac anesthesia for children undergoing transthoracic device closure of VSD has been carried out in our center in an attempt to help patients recover faster by shortening the anesthesia time, hastening the removal of the endotracheal tube and reducing the ICU stay [ 16 , 17 ] . Emergence delirium on awakening from general anesthesia would definitely affect postoperative recovery.…”

Evaluation of analgesic and sedative effects of remifentanil‐based fast‐track anesthesia in children undergoing transthoracic device closure of ventricular septal defects

“…The goal of fast‐track cardiac anesthesia is to reduce stress, relieve pain, and speed recovery, reduce hospitalization costs, and save medical resources. This technology's fundamental purpose is to replace long‐acting opioids with short‐acting opioids or to reduce the dosage of long‐acting opioids combined with inhaled anesthetics and other short‐acting intravenous anesthetics to achieve early recovery of spontaneous breathing and circulation 5,6,13–15 . Fast‐track anesthesia has been applied and studied in pediatric congenital cardiac surgery, but its application in transthoracic device closure of pediatric congenital VSDs under TEE guidance is rarely reported.…”

“…Transthoracic device closure of VSDs has the advantages of a small incision, rapid recovery, fewer complications, and avoidance of radiation exposure compared with surgical repair and percutaneous device closure 3,4 . Our center has carried out the application of remifentanil‐based fast‐track anesthesia in children undergoing transthoracic device closure of VSDs, which is conducive to early extubation, and reduced anesthesia time and length of intensive care unit (ICU) and hospital stay 5,6 . However, there are few reports about the effects of postoperative analgesia and sedatives in these patients.…”

“…3,4 Our center has carried out the application of remifentanil-based fast-track anesthesia in children undergoing transthoracic device closure of VSDs, which is conducive to early extubation, and reduced anesthesia time and length of intensive care unit (ICU) and hospital stay. 5,6 However, there are few reports about the effects of postoperative analgesia and sedatives in these patients. This study aimed to explore remifentanil on postoperative analgesic and sedative effects in children undergoing transthoracic device closure of VSDs by the fast-track anesthesia method.…”

Effect of remifentanil-based fast-track anesthesia on postoperative analgesia and sedation in adult patients undergoing transthoracic device closure of ventricular septal defect

“…To meet the needs of early extubation and short ICU stay after transthoracic device closure of VSD, fast-track anesthesia technology was used in our center. The fasttrack anesthesia technique, which means to help patients regain consciousness and spontaneous breathing as soon as possible, and usually tracheal extubation within 6 h after operation [15][16][17][18]. Fast-track cardiac anesthesia technology is not only an anesthetic measure to help patients recover quickly after the operation but also one of the improvement measures to accelerate the anesthesia management in the perioperative period of rehabilitation.…”