Use of High Spinal Anesthesia, General Anesthesia Affects Postoperative Recovery in Pediatric Patients Undergoing Congenital Heart Surgery

The use of both high spinal anesthesia (HSA) and general anesthesia (GA) may lead to fast-track recovery in pediatric patients undergoing congenital heart surgery. These findings were presented at the 22nd Annual Pain Medicine Meeting in New Orleans, Louisiana.

Researchers conducted a retrospective review that included pediatric patients younger than 18 years of age who underwent congenital heart surgeries. The cases they evaluated were divided into two groups: (1) those who received HSA in combination with GA (HSA group); (2) those who received GA only, without any additional neuraxial blocks (GA group). The primary outcome of the study was the extubation rate in the operating room.

In total, 629 surgical cases were used in the study. The researchers found that the rates of extubation in the operating room within 6 hours were higher in the HSA group compared with the GA group. Further, the length of stay in the ICU and the hospital were shorter in the HSA group compared with the GA group.

Additionally, the postoperative opioid requirement in the first 24-hours was found to be lower in the HSA group. And complications related to the use of HSA, such as hypotension and epidural hematoma, were not observed in the HSA group.

“Our study provides preliminary evidence on the impact and benefits of HSA on fast-track recovery following pediatric congenital heart surgery. Our results show that the patients in the HSA group were more likely to be extubated in the operating room and spent less time on postoperative mechanical ventilation, in addition to having a decreased stay in the ICU and hospital overall,” the researchers concluded. “Future prospective well-designed, randomized clinical trials are warranted to verify these outcomes.”

Reference:

Sivamurugan A, Sadek N, Sondekoppam R, et al. Impact of high spinal anesthesia in pediatric congenital heart surgery on fast-track recovery. Presented at: 22nd Annual Pain Medicine Meeting; November 10-11, 2023; New Orleans, LA. Accessed January 5, 2024. www.asra.com/docs/default-source/events-education-documents/pm23/abstract-4985.pdf?sfvrsn=71bcf90f_1/