Anesthetic management and outcome following noncardiac surgery in nonparturients with Eisenmenger's physiology

J Clin Anesth. 1996 Aug;8(5):341-7. doi: 10.1016/0952-8180(96)00084-0.


Study objective: To evaluate the perioperative risk to nonparturients with Eisenmenger's physiology for noncardiac surgical procedures.

Design: Retrospective chart review.

Setting: University-affiliated hospital.

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

Measurements and main 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%.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, Epidural
  • Anesthesia, General*
  • Anesthesia, Local*
  • Cesarean Section
  • Child
  • Child, Preschool
  • Conscious Sedation
  • Delivery, Obstetric
  • Eisenmenger Complex / surgery*
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Labor, Obstetric
  • Male
  • Middle Aged
  • Monitoring, Intraoperative / instrumentation
  • Nerve Block
  • Postoperative Care
  • Pregnancy
  • Preoperative Care
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Treatment Outcome