BISPECTRAL INDEX (BIS) MONITORING IN THE PERIOPERATIVE PERIOD DURING SURGICAL CORRECTION OF VENTRICULAR SEPTAL DEFECT IN CHILDREN

Аннотация

Ventricular septal defect (VSD) is the most frequently diagnosed congenital heart anomaly requiring surgical correction in early childhood. Anesthetic management of these patients presents specific challenges related to left-to-right shunting, pulmonary hyperperfusion, risk of pulmonary hypertensive crises, and limited hemodynamic reserve, which make conventional clinical criteria for assessing anesthesia depth insufficiently reliable. Both inadequate and excessive depth of anesthesia may lead to adverse perioperative events from intraoperative awareness and stress-induced hemodynamic instability to prolonged drug-induced myocardial and respiratory depression. Objective neuromonitoring of the level of hypnosis using the Bispectral Index (BIS) may allow for more accurate and individualized titration of anesthetics, thereby improving the safety and quality of perioperative management in pediatric patients undergoing VSD closure.