Paediatric anaesthesiaThe pediatric cardiac patient presenting for noncardiac surgerySümpelmann, Robert; Osthaus, Wilhelm Alexander Author Information Zentrum Anästhesiologie, Medizinische Hochschule Hannover, Hannover, Germany Correspondence to Professor Dr R. Sümpelmann, Zentrum Anästhesiologie-OE 8050, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany Tel: +49 511 532 9080; fax: +49 511 532 9048; e-mail: [email protected] Current Opinion in Anaesthesiology: June 2007 - Volume 20 - Issue 3 - p 216-220 doi: 10.1097/ACO.0b013e3280c60c89 Buy Metrics Abstract Purpose of review To summarize results of recent papers and discuss current trends concerning anesthesia in children with congenital heart disease presenting for noncardiac surgery. Recent findings Children with congenital heart disease have a significant incremental risk when presenting for minor or major surgery. It is a current trend that noncardiac surgery should be performed in pediatric centers, which have anesthesiologists and pediatricians familiar with the multiple specialties of children with congenital heart disease. A careful preoperative evaluation using a multidisciplinary approach is of great importance. In recent studies and case reports, the safe use of newer anesthetic agents, such as sevoflurane or desflurane, was reported in combination with opioids or regional blocks. In addition to standard monitors, invasive monitoring should be considered liberally perioperatively in patients with limited hemodynamic reserve and with major surgery. Several case reports reported that laparoscopic surgery was successfully performed even in high-risk patients with congenital heart disease. Summary Careful preoperative evaluation, experienced anesthesiologists, suitable anesthetic agents and techniques, and the liberal use of invasive monitoring are integral parts of safe and effective anesthetic care in children with congenital heart disease. Future studies have to show whether laparoscopic surgery may be beneficial in this special subgroup of patients. © 2007 Lippincott Williams & Wilkins, Inc.