Anasthesie bei Operationen angeborener Herzfehler: Ergebnisse einer Umfrage in Deutschland

Results of a recent surgery revealed interesting changes concerning anaesthetic management since a previous survey in 1986: 1. The number of drugs used for premedication, induction and maintenance of anaesthesia has been markedly reduced. 2. In the absence of an intravenous cannula, volatile anaesthetic agents like isoflurane, sevoflurane, and halothane are still frequently used for induction of anaesthesia. For maintenance of anaesthesia these agents are not used alone, however, but as components of balanced anaesthesia in many institutions. Concerning the benzodiazepines there is a trend to short acting agents. Fentanyl remained the most frequently used opioid. Alfentanil, in contrast, did not gain popularity. Pancuronium is the most widely used muscle relaxant. 3. Standard monitoring techniques (including arterial and central venous catheters) were used. Transoesophageal echocardiography is being performed more and more, particularly to evaluate the quality of surgical correction. 4. Extracorporeal circulation is nearly always performed by membrane oxygenator. 5. For the management of pediatric cardiac patients an additional training of at least 12 months is recommended.