ANESTHETIC PROBLEMS IN CARDIAC SURGERY IN CHILDREN

Abstract

In anesthesia in cardiac surgery in children, the extreme hypoxia of cardiac children makes depression of metabolic activity and psychic sedation the most important considerations of preoperatlve medication. The use of relatively large doses of morphine and atropine, or morphine and scopolamine is recommended in all cases. Age, not wt., is the determining factor in the size of the dose. Before making a choice of anesthetic agent or technic to be used for an operative procedure, one must consider the requirements of both the patient and the surgeon. Cyclopropane was used as the principal agent for all cardiac surgical procedures. All children are intubated before being turned on their sides. Atropine in soln. is used to stimulate heart action. The use of hypothermia to reduce metabolism during operation, particularly in hypoxic children, is suggested. Operative complications such as pulmonary decompensation are discussed. For the postoperative complication of laryngeal edema, children are placed in a "steam room," a room with very high humidity but with a max. temp. of 75[degree] F. Anoxia is the most frequent cause of death in the series of patients studied. Cerebral hemorrhage or cerebral thrombosis was next in frequency.