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Seminars in Cardiothoracic and Vascular Anesthesia
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The Use of Regional Anesthesia in Combination With General Anesthesia for Cardiac Surgery in Children

Gregory B. Hammer

Departments of Anesthesia, Pediatrics, and Cardiothoracic Surgery, Stanford University Medical Center, Stanford, CA

Vinit Wellis

Departments of Anesthesia, Pediatrics, and Cardiothoracic Surgery, Stanford University Medical Center, Stanford, CA

M. Gail Boltz

Departments of Anesthesia, Pediatrics, and Cardiothoracic Surgery, Stanford University Medical Center, Stanford, CA

Shoichi Uezono

Departments of Anesthesia, Pediatrics, and Cardiothoracic Surgery, Stanford University Medical Center, Stanford, CA

Mark D. Rodefeld

Departments of Anesthesia, Pediatrics, and Cardiothoracic Surgery, Stanford University Medical Center, Stanford, CA

Nancy A. Pike

Departments of Anesthesia, Pediatrics, and Cardiothoracic Surgery, Stanford University Medical Center, Stanford, CA

Michael D. Black

Departments of Anesthesia, Pediatrics, and Cardiothoracic Surgery, Stanford University Medical Center, Stanford, CA

The use of regional anesthesia in combination with general anesthesia for children undergoing cardiac surgery is the subject of a growing number of publications and presenta tions. Benefits of regional anesthesia in patients having car diac surgery include attenuation of the neuroendocrine response to surgical stress, improved postoperative pulmo nary function, enhanced cardiovascular stability, and im proved postoperative analgesia. To the extent that regional anesthesia facilitates early tracheal extubation in cardiac surgical patients, complications and costs associated with postoperative mechanical ventilation may be reduced. These benefits must, however, be weighed against the ad verse effects that may accompany the use of regional anes thesia, including hypotension, postoperative respiratory de pression, and epidural hematoma formation. In this article, the benefits and risks of regional anesthesia in infants and children undergoing open heart surgery are reviewed. In addition, specific spinal and epidural techniques currently in use are described, including management of side effects. Copyright © 2001 by W.B. Saunders Company.

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 5, No. 1, 105-112 (2001)
DOI: 10.1053/scva.2001.21566
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