Experience with remifentanil/remifentanil - sevoflurane anesthesia for surgical ligation of patent ductus arteriosus (PDA) in premature infants in the neonatal intensive care unit: A case report

ABSTRACT

Surgical ligation of PDA is an effective treatment for symptomatic infants who do not respond to treatment with indomethacin. Transfer of unstable infants to the operating room has been shown to be associated with various problems. Thus, we describe the anesthetic management of 5 extremely low birth weight (ELBW) infants who underwent surgical ligation of PDA in a neonatal intensive care unit (NICU). General anesthesia was induced by ketamine 1 mg/kg IV. Rocuronium was used for muscle relaxation. Anesthesia was maintained with continuous infusion of remifentanil 0.15-0.4 ug/kg/min with oxygen (in 2 cases) or continuous infusion of remifentanil 0.05-0.1 ug/kg/min and 0.4-1.0 vol% sevoflurane with oxygen (in 3 cases). It was safe and effective to perform bedside PDA ligation in the NICU. We describe the successful use of remifentanil with sevoflurane or remifentanil alone in 5 extremely low birth weight infants undergoing PDA ligation.