ABSTRACT
Abstract Gastroschisis is a congenital anomaly characterized by a defect in the anterior abdominal wall with protrusion of abdominal viscera. Perioperative mortality is very high in these patients. Traditionally gastroschisis repair has been performed under general anesthesia with endotracheal intubation, requiring postoperative intensive care admission and mechanical ventilation. Caudalblock is an attractive alternative to general anesthesia. We present a series of three neonates with gastroschisis, repaired solely under caudal anesthesia.
Resumo Gastrosquise é uma anomalia congênita caracterizada por um defeito da parede abdominal anterior com protrusão de vísceras abdominais. A mortalidade no período perioperatório é muito elevada nesses pacientes. Tradicionalmente, a correc¸ão de gastrosquise tem sido feita sob anestesia geral com intubac¸ão orotraqueal, o que requer internac¸ão em unidade de terapia intensiva e ventilac¸ão mecânica no pós-operatório. O bloqueio caudal é uma opc¸ão atraente à anestesia geral. Apresentamos uma série de três casos de recém-nascidos com gastrosquise corrigida unicamente sob anestesia caudal.
Subject(s)
Humans , Infant, Newborn , Gastroschisis/surgery , Anesthesia, CaudalABSTRACT
The association of congenital pulmonary airway malformation (CPAM) with congenital heart disease is rare. We present the case of a 6‑month‑old child with atrial septal defect and pulmonary hypertension (PH) who presented with severe respiratory distress and hypoxia. The patient underwent right lobectomy for CPAM. With timely management, real‑time monitoring, one lung ventilation, and adequate analgesia, we were able to extubate the child in the immediate postoperative period. We conclude that with meticulous planning and multidisciplinary team approach, such complex cases can be managed successfully.