Association Between Inhalational Anesthesia-Related Complications and Intraoperative Hemodynamic Changes in Patients Undergoing Congenital Cardiac Surgery
TL;DR
Findings indicate that inhalational anesthesia-related complications are associated with significant intraoperative hemodynamic changes, with arrhythmias exerting the greatest impact on cardiovascular stability.
Abstract
Inhalational anesthetics are widely used in congenital cardiac surgery; however, anesthesia-related complications may affect intraoperative hemodynamic stability and surgical outcomes. This study evaluated the association between inhalational anesthesia-related complications and intraoperative hemodynamic parameters in patients undergoing surgery for congenital heart diseases (CHDs). A descriptive multicenter study was conducted between December 2025 and May 2026 at I.R.C.C.S. Policlinico San Donato Milanese (Italy), Tripoli Medical Hospital (Libya), and the Turkish Medical Team at Fallujah Hospital (Iraq). Patients undergoing congenital cardiac surgery under inhalational anesthesia were included. Data on CHD classification and intraoperative hemodynamic parameters were collected. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded at 10, 20, 30, 40, 50, and 60 minutes during surgery. Statistical analysis was performed using SPSS version 21, with descriptive statistics and ANOVA used to assess differences according to anesthesia-related complications. A total of 23 patients were included. Cyanotic septal defects were the most common CHD category (61.7%), followed by cyanotic complex defects (23.4%). Significant differences in SBP were observed at 50 minutes (p=0.038) and 60 minutes (p=0.032), while DBP showed significant differences at both time points (p=0.01). Heart rate differed significantly at 20 minutes (p=0.048) and demonstrated a highly significant difference at 30 minutes (p=0.0001), particularly among patients who developed arrhythmias. These findings indicate that inhalational anesthesia-related complications are associated with significant intraoperative hemodynamic changes, with arrhythmias exerting the greatest impact on cardiovascular stability. Continuous cardiovascular monitoring remains essential during congenital cardiac surgery to optimize patient safety and perioperative outcomes.