Association Between Inhalational Anesthesia-Related Complications and Intraoperative Hemodynamic Changes in Patients Undergoing Congenital Cardiac Surgery

Ghada Alnaeli; Sara Hwisa; Ahmed Aljileedi; Ebtihal Al-Hallak; Hadeel Omara; Hanadi Al-Ahwal; Hanan Al-Shaibani; Mohammed Al-Shibani; Rawasi Omara; Rayan El-Baruni; Retaj Hamouda

doi:10.54361/ajmas.269738

Authors

Ghada Alnaeli Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0009-0004-8736-468X
Sara Hwisa Department of Medical Science, Faculty of Dentistry, Sabratha University, Az-Zāwiyah, Libya https://orcid.org/0009-0005-1900-8453
Ahmed Aljileedi Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0000-0003-4111-4365
Ebtihal Al-Hallak Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0009-0003-8366-2869
Hadeel Omara Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0000-0002-1696-5574
Hanadi Al-Ahwal Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0000-0003-4486-2545
Hanan Al-Shaibani Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0009-0006-9855-415X
Mohammed Al-Shibani Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0009-0003-4777-0299
Rawasi Omara Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0000-0002-6600-2434
Rayan El-Baruni Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0009-0007-8302-4524
Retaj Hamouda Department of Anesthesia, Faculty of Medical Technology- Surman, University of Sabratha, Az-Zāwiyah, Libya https://orcid.org/0000-0002-1082-6186

DOI:

https://doi.org/10.54361/ajmas.269738

Keywords:

Inhalational Anesthesia, Congenital Heart Disease, Arrhythmia, Hemodynamic Parameters

Abstract

Inhalational anesthetics are widely used in congenital cardiac surgery; however, anesthesia-related complications may affect intraoperative hemodynamic stability and surgical outcomes. This study evaluated the association between inhalational anesthesia-related complications and intraoperative hemodynamic parameters in patients undergoing surgery for congenital heart diseases (CHDs). A descriptive multicenter study was conducted between December 2025 and May 2026 at I.R.C.C.S. Policlinico San Donato Milanese (Italy), Tripoli Medical Hospital (Libya), and the Turkish Medical Team at Fallujah Hospital (Iraq). Patients undergoing congenital cardiac surgery under inhalational anesthesia were included. Data on CHD classification and intraoperative hemodynamic parameters were collected. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded at 10, 20, 30, 40, 50, and 60 minutes during surgery. Statistical analysis was performed using SPSS version 21, with descriptive statistics and ANOVA used to assess differences according to anesthesia-related complications. A total of 23 patients were included. Cyanotic septal defects were the most common CHD category (61.7%), followed by cyanotic complex defects (23.4%). Significant differences in SBP were observed at 50 minutes (p=0.038) and 60 minutes (p=0.032), while DBP showed significant differences at both time points (p=0.01). Heart rate differed significantly at 20 minutes (p=0.048) and demonstrated a highly significant difference at 30 minutes (p=0.0001), particularly among patients who developed arrhythmias. These findings indicate that inhalational anesthesia-related complications are associated with significant intraoperative hemodynamic changes, with arrhythmias exerting the greatest impact on cardiovascular stability. Continuous cardiovascular monitoring remains essential during congenital cardiac surgery to optimize patient safety and perioperative outcomes.