<![CDATA[Anesthesia in pediatric patients with acyanotic congenital heart disease requires a specialized approach due to complex interactions between cardiac anatomy and physiology, as well as the risk of perioperative hemodynamic instability. A two-month-old, 5-kg infant presented with a congenital heart defect and a left eyelid anomaly present since birth. Physical examination revealed superior palpebral coloboma with symblepharon and exposure keratitis. The patient was scheduled for surgical repair, and preoperative assessment identified anemia and thrombocytosis. Anesthetic management included preoperative fasting, fluid calculation, and premedication with atropine sulfate 0.1 mg and intravenous fentanyl 15 mcg (2–3 mcg/kg body weight). Intubation was facilitated using atracurium, and anesthesia maintenance was achieved with sevoflurane and fentanyl. Intraoperative monitoring ensured adequate end-tidal CO₂ (EtCO₂) levels and oxygen saturation. The one-hour procedure addressed the eyelid defect, followed by postoperative analgesia. The patient was monitored for three days postoperatively and discharged on the fourth day. Previous studies have shown that children with congenital heart disease undergoing non-cardiac surgery face increased perioperative risks influenced by factors such as overall condition and disease severity. Accordingly, clinical outcomes are highly dependent on anesthesia management tailored to these physiological considerations. Pediatric patients with congenital heart disease can safely undergo general anesthesia for non-cardiac procedures when comprehensive preoperative preparation and meticulous intraoperative monitoring are implemented.]]>
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