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Evaluation of Anesthesia Management of Pediatric Cardiac Surgery with Cardiopulmonary Bypass on Piglets

WANG Xiao-cou1,XUE Qing-hua1,YAN Fu-xia1,LI Li-huan1,LI Shou-jun2,HU Sheng-shou2(1.Department of Anesthesiology,Cardiovascular Institute and Fuwai Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100037,China;2.Department of Cardiovascular Surgery,Cardiovascular Institute and Fuwai Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100037,China)  
Objective To evaluate the effectiveness and safety of anesthesia management of pediatric cardiac on piglets with low tempe-rature and low flow cardiopulmonary bypass(CPB).Methods Forty-two general-type piglets were utilized,with ketamine and atropine intramuscular injection as basal anaesthesia,fentanyl,pipecuronium bromide,midazolam were intravenously injected and sevoflurane was inhaled for anesthesia induction and maintenance.Mechanical ventilation was discontinued after full flow CPB,0.49 kPa pressure of adjustable pressure limiting valve was used to keep lungs slightly inflated.Airway secretions were suctioned regularly and manual ventilation was given to expand lungs once the circulation restarted,and then full mechanical ventilation was reinstated.Internal environment disorder was rectified according to the result of arterial blood gases analysis,and dopamine and dobutamine were intravenously injected by pump in order to maintain circulation steadiness,while arrhythmias was corrected according to their types.Haemodynamics,arterial blood gas analysis,breath parameters,duration of anesthesia,CPB and aorta arrest were monitored and recorded.Results One piglet died of heart arrest after CPB,while other 41 cases went through and completed the experiments.Durations of aortic cross clamp,CPB,and anesthesia maintain were(125±8) min,(184±10) min,(335±17) min,separately.Conclusion Anesthesia management of pediatric cardiac surgery with CPB on piglets has pre-ferable anesthesia effectiveness and safety.
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