Anesthetic management and outcome following noncardiac surgery in nonparturients with Eisenmenger's physiology.
OBJECTIVE
To evaluate the perioperative risk to nonparturients with Eisenmenger's physiology for noncardiac surgical procedures.


METHODS
Retrospective chart review.


METHODS
University-affiliated hospital.


METHODS
12 nonparturients with Eisenmenger's physiology who underwent 25 noncardiac surgical procedures requiring care by an anesthesiologist.


RESULTS
Preoperative, intraoperative, and postoperative records were retrospectively analyzed. Data examined included patient age, gender, symptoms, laboratory values, monitors used, surgical procedure, and outcome. Twenty-five procedures were performed on 12 patients; 13 procedures were performed with general anesthesia, 6 with peripheral nerve blocks, 5 with sedation by an anesthesiologist with or without local anesthetic infiltration, and one with epidural anesthesia. One patient died perioperatively. Review of the literature revealed two deaths in 32 procedures for nonparturients with Eisenmenger's physiology undergoing noncardiac surgery.


CONCLUSIONS
A variety of anesthetic techniques and drugs may be used successfully in nonparturients with Eisenmenger's physiology undergoing noncardiac surgery. Although the study group is small, the perioperative mortality risk is lower than that for parturients undergoing either labor and delivery or cesarean section and is probably in the range of approximately 10%.
Raines
D E
DE
Department of Anesthesia, Massachusetts General Hospital, Boston 02114, USA.
Liberthson
R R
RR
Murray
J R
JR
D000293:Adolescent; D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000772:Anesthesia, Local; D002585:Cesarean Section; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D036861:Delivery, Obstetric; D004541:Eisenmenger Complex / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation; D009407:Nerve Block; D011182:Postoperative Care; D011247:Pregnancy; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome