Fast-tracking and regional anesthesia in pediatric patients undergoing congenital heart surgery

Abstract

Early extubation and adequate postoperative pain control are central components of fast-tracking pediatric patients undergoing congenital heart surgery (CHS). The term fast-tracking is typically associated with the multidisciplinary approach to decreasing morbidity and costs associated with prolonged hospital length of stay. Planning an anesthetic for fast-tracking CHS patients typically includes the use of short-acting anesthetic drugs and, frequently, the use of regional and in particular neuraxial anesthesia techniques. This chapter will focus on the anesthesiologist’s role in fast-tracking pediatric patients undergoing CHS, including anesthetic management, patient selection, and risks and benefits of such an approach.