Dr. Prabhakar  Devavaram  Mbbs image

Dr. Prabhakar Devavaram Mbbs

300 Longwood Ave
Boston MA 02115
617 557-7731
Medical School: Other - 1989
Accepts Medicare: Yes
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 209765
NPI: 1629046909
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Anesthetic implications of primary cardiac tumors in infants and children. - Journal of cardiothoracic and vascular anesthesia
To determine the degree of hemodynamic and airway compromise in infants and children undergoing anesthesia for primary cardiac tumors.Retrospective study.Tertiary-care, academic children's hospital.Patients <18 years old who had undergone anesthesia and surgery for resection or biopsy of a primary cardiac tumor (n = 25).None.Charts were reviewed for intraoperative complications, defined as (1) hypotension (20% decrease from baseline) during or after induction; (2) failure to gain airway control by insertion of an airway or endotracheal intubation, inability to ventilate after administration of a muscle relaxant, need for change in patient position, rigid bronchoscopy, or cardiopulmonary bypass for adequate oxygenation; and (3) new arrhythmias. Hypotension during induction occurred in 4 patients (16%), 3 of whom were hemodynamically unstable preoperatively. Hypotension after induction was found in 2 (8%) patients. Hypotension occurred more frequently in patients with obstruction to blood flow and arrhythmia (n = 3), obstruction to blood flow only (n = 1), and arrhythmia only (n = 1). No patient had airway difficulty related to the tumor, although one intrapericardial tumor mimicked an anterior mediastinal mass. New arrhythmias occurred in 3 (12%) patients.The subgroup of patients at greatest risk are patients with a combination of obstruction to blood flow and arrhythmias. Despite the alarming diagnosis, the intraoperative course tends to be fairly stable in most cases. Extensive pericardial tumors may produce the same airway concerns as anterior mediastinal masses, but airway complications do not seem to be a problem with intrachamber tumors.Copyright 2002, Elsevier Science (USA). All rights reserved.

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