[Anesthesia for aorto-coronary bypass graft surgery in children with Kawasaki disease]

Abstract

We investigated anesthetic management of aorto-coronary bypass graft surgery (CABG) in the children who have coronary disease due to acute febrile mucocutaneous lymph node syndrome (Kawasaki disease). A retrospective observation was made on anesthetic management of 17 patients with Kawasaki disease. They were 13 boys and 4 girls and their ages ranged from 5 to 13 years. They underwent CABG during the past 10 years (1976-1986) in Tokyo Women's Medical College Daini Hospital. Induction of anesthesia was carried out with halothane-nitrous oxide-oxygen (GOF) in 16 patients and morphine-nitrous oxide-oxygen (GOM) in one patient. Anesthesia was maintained with GOF in 11 patients, and in 6 patients with GOF and narcotics. High-dose fentanyl was not used for anesthetic induction in children with Kawasaki disease. Pulse rate increased significantly after endotracheal intubation. Blood pressure increased after endotracheal intubation in 5 patients and after sternotomy in one patient. Hypotension developed in 2 patients. Coronary spasm did not occur during the all procedures. Control of blood pressure during CABG in children was easier than in adult patients. But the control of pulse rate offers a problem in anesthetic management of the children with Kawasaki disease.