How is Anesthesia Used During Heart Surgery?
The Department of Anesthesia Cincinnati Children's Hospital Medical Center cares for a large number of children with both congenital and acquired heart disease. Many of these children will have procedures that need anesthesia (a medical treatment that prevents patients from feeling pain during surgery). By understanding your child's heart problems, the anesthesiologist (a doctor who manages medicines (anesthesia) before and during surgery) can make a plan that works best for your child.
Anesthetic care is given to children during these common procedures:
- Complex neonatal heart repairs. This may include the arterial switch operation for transposition of the great arteries. It may also include the Norwood procedure for hypoplastic left heart syndrome.
- Closure of ventricular and atrial septal defects
- Aortic coarctation repairs
- Placement of pacemakers
- Atrial septal defects device closures
- Placement of stents
For information on these procedures and more, please see the Cincinnati Children's Heart Center Encyclopedia.
Before the Surgery
Before the procedure, you and your child will meet with an anesthesiologist. You will be asked questions about your child's heart history, allergies, medications and other health issues. It is important to let the anesthesiologist know of any problems with anesthesia in the past and any recent illnesses.
Before going to sleep for a procedure, many children are sedated with a medication taken by mouth. This helps to relax the child. It also makes the separation process from the parents' smoother. These medicines can cause the child to forget what happened.
During the Surgery
In most children, general anesthesia starts by breathing anesthetic gas through a mask. In older children, general anesthesia will be started through an IV.
For most procedures, a breathing tube will be placed after your child is asleep. Your child will be on a ventilator (a breathing machine) during the procedure. The specific anesthetic agents your child gets will depend on your child's heart disease, the procedure performed, and if continued sedation and mechanical ventilation will be needed after the procedure.
After the Surgery
If a heart-lung bypass machine is used, most children are kept sedated with a breathing tube in place for a while after the procedure. These patients are cared for in the Cardiac Intensive Care Unit (CICU).
During this time, treating your child’s pain is important. Some children are kept on a continuous infusion of pain medicine. Others are given pain medications as needed. In older children, a patient-controlled analgesic (PCA) pump may be used to help control pain. We will talk to you about this if it is needed for your child