Anaesthetic management for surgical correction of coarctation of aorta

In this paper we have reviewed the anaesthetic management of 57 consecutive patients who underwent surgical correction of coarctation of aorta. The patients were divided into two groups. In group I of ten patients, no volume preloading was done prior to the release of aortic cross-clamp and the declamping hypotension was managed by rapid infusion of fluids along with correction of metabolic acidosis. In group II of 47 patients, volume preloading was done along with administration of sodium bicarbonate 1 mEq/kg just prior to declamping. Statistically significant (p<0.05) decrease in the systolic and diastolic pressures were observed after declamping in group I; whereas in group II, the hypotension observed was statistically insignificant. Declamping hypotension can thus be prevented or minimised by appropriate volume preloading and correction of existing metabolic acidosis just prior to the release of aortic cross-clamp.