Retrospective evaluation of anaesthesia management in children with CHD undergoing procedures in the paediatric cardiology catheterization laboratory

Abstract Background: Paediatric cardiac catheterization in children with CHD requires anaesthetic techniques that balance procedural conditions with physiological risk. We evaluated anaesthesia management at a tertiary centre and examined associations between anaesthesia strategy and peri-procedural outcomes. Methods: This single-centre retrospective cohort included 307 catheterization procedures after exclusions. Anaesthesia was categorized as general anaesthesia or sedation. The primary outcome was any recorded complication. Results: Median age was 7.0 years (interquartile range 2.0–13.0), and 155/307 (50.5%) procedures were performed under general anaesthesia and 152/307 (49.5%) under sedation. Overall, 49/307 (16.0%) procedures were associated with at least one recorded complication; complications were more frequent with general anaesthesia than with sedation (20.6% versus 11.2%, p = 0.024). In diagnostic catheterization/angiography ( n = 175), general anaesthesia was independently associated with higher odds of any complication compared with sedation (adjusted odds ratio 2.78, 95% confidence interval 1.12–6.91; p = 0.028). Conclusions: In this cohort, general anaesthesia was associated with higher recorded complication rates than sedation, and this association persisted after adjustment within diagnostic catheterizations. Comparisons within interventional procedures were limited by sparse sedation data. These findings support procedure-specific, risk-adjusted evaluation when selecting anaesthesia strategy in the paediatric catheterization laboratory.