ABSTRACT
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Subject(s)
Humans , Female , Adult , Analgesia/methods , Analgesia , Obesity, Morbid/complications , Obesity, Morbid/diagnosis , Drug Hypersensitivity/complications , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/drug therapy , Cesarean Section/methods , Tramadol/therapeutic use , Postoperative Care/methods , Hypertension/complications , Sleep Apnea Syndromes/complications , Bupivacaine/metabolism , Bupivacaine/therapeutic use , Fentanyl/metabolism , Fentanyl/therapeutic useSubject(s)
Cesarean Section , Drug Hypersensitivity/complications , Nerve Block , Obesity, Morbid/complications , Pain, Postoperative/drug therapy , Pregnancy Complications , Adult , Amides , Anesthesia, Epidural , Anesthesia, Obstetrical , Anesthesia, Spinal , Anesthetics, Local , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Contraindications , Emergencies , Female , Humans , Hypertension, Pregnancy-Induced , Narcotics/therapeutic use , Pain, Postoperative/prevention & control , Pregnancy , Ropivacaine , Sleep Apnea, Obstructive/complications , Subarachnoid Space , Tramadol/therapeutic useABSTRACT
La pentalogía de Cantrell es una rara malformación congénita caracterizada por un amplio defecto de la región inferior del esternón, el diafragma y la región anterior abdominal. Se caracteriza por la migración de órganos y su pronóstico depende de la presencia de malformaciones cardiacas. Presentamos el caso de un varón de 18 años sometido a corrección programada de un onfalocele gigante. Se empleó monitorización invasiva y del gasto cardiaco para evitar (como había sucedido en dos intervenciones previas) episodios de inestabilidad por aumento de la presión intraabdominal y disminución del retorno venoso. El pronóstico depende de múltiples factores; lo más importante es el buen control hemodinámico y respiratorio. A pesar de la monitorización avanzada, la mortalidad es muy alta(AU)
Pentalogy of Cantrell is a rare congenital malformation characterised by a large defect in the lower region of the sternum, diaphragm, and lower abdominal region. It is also characterised by the migration of organs, and its prognosis depends on the presence of cardiac malformations. We present the case of an 18 year-old male subjected to a scheduled giant omphalocele correction. Invasive monitoring, including cardiac output, was used to avoid episodes of instability due to the increase in abdominal pressure and the increase in venous return (as had happened on two previous operations). The prognosis depends on multiple factors, with good haemodynamic and respiratory control being the most important. Mortality is high despite the advances in monitoring(AU)