Abstract

DE LA PARTE PEREZ, Lincoln. Anestesia regional para cirugía cardiovascular pediátrica. Rev Cubana Pediatr [online]. 2004, vol.76, n.1. ISSN 0034-7531.

Several articles have been published on the use of spinal and epidural anesthesia associated with general anesthesia in children undergoing cardiovascular surgery. The use of this technique causes a significant decrease of the stress response observed during and after cardiovascular surgery and that is particularly intense in newborns and infants. Besides, it produces a better pulmonary function, a longer hemodynamic stability, the possibility of fast track cardiac anesthesia, an excellent postoperative analgesia and a shorter stay in the anesthetic recovery ward. The most important complications associated with its use are arterial hypotension, respiratory depression and epidural hematoma. The most significant contraindications on applying these techniques include the presence of cyanosis, polycythaemia, preexisting coagulopathy and infants under 6 months of age. There is also a marked ethical dilemma in relation to its use. On one hand, it is true that a series of advantages may be obtained that could be also attained by using other techniques directed to fast track cardiac anesthesia and, on the other hand, there is always a latent danger of bleeding and of an epidural hematoma formation. A bibliographic review on the different techniques used is made.

Keywords : ANESTHESIA, CONDUCTION [methods]; THORACIC SURGERY; CADIOVASCULAR SURGICAL PROCEDURES; INFANT; INFANT NEWBORN.