Importance of Anesthesia (and Anesthesiologist) in Pediatric Cardiac Surgery

The children are not kind of “minimized” adults. They are totally different individuals who have different physiology and growing dynamics from adults. Anesthesia method largely differs in pediatric patients by age, weight of the patient and type of surgical operation. A child with a congenital heart disease might need an anesthesiologist in many different ways. This child could be a teen who appears to grow healthily and develop normally or it could be a cyanotic newborn that seems severely ill.

It is very important for the child and his/her family to be ready for a pediatric cardiac surgery. The patient and his/her parents meet the anesthesiologist at evaluation prior to the surgery. The family, and sometimes the child, must be clearly explained about the medication taken before anesthesia, type of anesthesia, anesthetics to use, the risk of anesthetic interventions, and possible complications. A cardiac surgery is a physiological and psychological trauma to children. It is therefore very important for the family and the development of child that the patient recovers from this process as comfortable as possible. So, pre-anesthesia drugs called premedication have a different role in pediatric anesthesia.

Premedication relaxes and calms the children and eliminates anxiety and nervousness in older children. These drugs preferentially are applied in the patient room and the patient is taken to the operating theatre when the drug starts to act on patient. So, the children do not remember operating theatre process. The crucial part of surgery and anesthesia in children is to place the instruments into child’s vein that monitor life signs during operation. This is extremely difficult and requires considerable experience for especially infants and newborns. This where the importance of an experienced anesthesiologist in pediatric anesthesia appears.

The anesthesiologist administers the anesthetics in appropriate dose and time to support child’s operation. Unlike adults, the dosage of drugs used in children largely varies by the age and height. This is the point where the experience of anesthesiologist in pediatric patients becomes highly important. The anesthesiologist monitors patient’s vital functions during surgery by means of instruments placed into the vein. Then she or he ensures a proper transfer of child to the intensive care at the end of operation.

The intensive care process following a heart surgery is a critical process requiring a team work. The anesthesiologist, cardiac surgeon, pediatric cardiologist and intensive care nurses work always in coordination. The patient is separated from the breathing device in a controlled manner; supportive care is reduced as required, and the patient is discharged from ICU as soon as possible as agreed by the team of congenital cardiac surgery. This is highly important for both patient’s psychology and parent’s peace.

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