Anaesthesia for craniotomy in a child with cardiac disease

Abstract

Background: Children with congenital heart disease (CHD) may present for non-cardiac surgery. Their anaesthetic management depends on their pre-morbid pathology.
Aim: To report the anaesthetic management of a patient with congenital heart disease for a non-cardiac surgery.
Case report: Craniotomy for evacuation of an intracerebral abscess was performed on a 4-year-old female child with severe congenital ventricular septal defect (VSD). Induction was with halothane, nitrous oxide and oxygen using a Mapleson F breathing circuit. Endotracheal intubation was performed after a second dose of suxamethonium was administered. Muscle relaxant was maintained using atracurium. Spontaneous ventilation was resumed at the end of operation, after a repeat reversal of muscle paralysis.
Lesson: The pathophysiology of CHD alters cardiovascular dynamics and therefore the uptake and distribution of anaesthetic agents


Keywords: Congenital heart disease, Anaesthesia, Pulmonary vascular pressure

Port Harcourt Medical Journal Vol. 1 (2) 2007: pp. 126-129