Anesthetic management for non-cardiac surgery in a patient with Fontan palliation

Henao-Solarte, María Camila; Uribe-Moreno, Mateo; Ríosa, Álvaro Ospina De los

doi:10.1097/cj9.0000000000000104

Cited by 2 publications

(1 citation statement)

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“…Therefore, anesthesia agents with minimal myocardial depression effects, such as thiopental or inhalation agents, should be used. 4,7,8 In this case, midazolam and ketamine were used for premedication, and sevoflurane was used for induction with the aim of not increasing pulmonary vascular resistance (PVR) and further depressing myocardial function.…”

Section: Discussionmentioning

confidence: 99%

Cochlear Implantation with Fontan Circulation: A Rare Case of Non-Cardiac Pediatric Surgery

I Putu Kurniyanta,

Adiyana

2023

Bioscmed

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Background: Fontan circulation is a cardiac circulation following the Fontan procedure in patients with a single ventricle congenital heart defect. This circulation depends on the difference in pressure between pulmonary capillaries and central venous pressure to achieve optimal cardiac output. This case report aims to discuss intraoperative anesthesia management in a patient with Fontan circulation undergoing a non-cardiac surgical operation. Case presentation: The patient is a 7-year-old male with a history of congenital heart disease who has undergone the Fontan circulation procedure and is now undergoing Cochlear implantation surgery. The patient was managed with general anesthesia - endotracheal intubation and controlled ventilation during the operation, following the principle of minimizing intrathoracic positive pressure, low PEEP, and low tidal volume with a target peripheral saturation > 95%. Cardiac output monitoring during the intraoperative period is done using intra-arterial blood pressure. After 5 hours of surgery, the patient was extubated with stable hemodynamics. Conclusion: The primary goal of intraoperative anesthesia management in patients with Fontan circulation is to maintain an optimal transpulmonary gradient by ensuring optimal transpulmonary blood flow, thus preserving cardiac output.

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Section: Discussionmentioning

confidence: 99%

Cochlear Implantation with Fontan Circulation: A Rare Case of Non-Cardiac Pediatric Surgery

I Putu Kurniyanta,

Adiyana

2023

Bioscmed

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Questions and answers

Raffán-Sanabria

2020

Colomb. j. anesthesiol.

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In 2019, the Pan-American Federation of Medical Schools (Fepafem, in Spanish), signed a declaration stating that education institutions must promote dynamic, top-quality, competencybased training processes. The name of that declaration is( 1): a. Cartagena. b. Lima. c. Buenos Aires. d. Montreal. 2. The so-called anesthesia awareness (AA) is a complication associated with different postoperative manifestations including sleep disorders, depressive episodes and fear of hospital settings. Which of the following statements regarding AA is false?(2) a. Incidence varies significantly between 1:600 and 1:17,000 patients. b. It may give rise to states of post-traumatic stress. c. The use of BIS to monitor the depth of anesthesia reduces the incidence of AA by 95%. d. Auditory evoked potentials have been used to determine the level of patient unconsciousness.

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Anesthetic management for non-cardiac surgery in a patient with Fontan palliation

Cited by 2 publications

References 13 publications

Cochlear Implantation with Fontan Circulation: A Rare Case of Non-Cardiac Pediatric Surgery

Cochlear Implantation with Fontan Circulation: A Rare Case of Non-Cardiac Pediatric Surgery

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