Document Detail


Perioperative anesthetic and analgesic management of newborn bladder exstrophy repair.
MedLine Citation:
PMID:  18644530     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Reconstruction of bladder exstrophy in newborn infants requires immobilization, sedation and pain management to prevent distracting forces from compromising the repair. We present a 6-year review of our experience. SUBJECTS AND METHODS: We reviewed the perioperative management of newborn infants undergoing reconstruction between November 1999 and October 2006. Data are presented as means+/-SD. RESULTS: Twenty-three newborn infants underwent surgery under a combined epidural and general anesthetic technique. Tunneled caudal epidural catheters were inserted in all patients and intermittently injected with 0.25% bupivacaine with 1:200,000 epinephrine. Postoperatively, a continuous infusion of 0.1% lidocaine, 0.8-1mg/kg/h was administered for 15+/-8 (range 4-30) days. Children were sedated with diazepam for 20+/-13 (range 2-40) days. Central venous catheters were maintained for 20+/-9 (range 1-34) days for fluids, drug administration and blood sampling. No patient experienced bladder prolapse or wound dehiscence. CONCLUSION: Perioperative management with tunneled epidural and central venous catheters in newborn infants with bladder exstrophy facilitates immobilization, analgesia and sedation, resulting in an excellent cosmetic repair with no case of bladder prolapse or wound dehiscence.
Authors:
Sabine Kost-Byerly; Eric V Jackson; Myron Yaster; Lori J Kozlowski; Ranjiv I Mathews; John P Gearhart
Publication Detail:
Type:  Journal Article     Date:  2008-04-01
Journal Detail:
Title:  Journal of pediatric urology     Volume:  4     ISSN:  1873-4898     ISO Abbreviation:  -     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-22     Completed Date:  2008-10-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101233150     Medline TA:  J Pediatr Urol     Country:  England    
Other Details:
Languages:  eng     Pagination:  280-5     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, the Johns Hopkins Hospital, Johns Hopkins University, School of Medicine, Baltimore, MD 21287, USA. skostby1@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Adjuvants, Anesthesia / administration & dosage
Anesthesia, Epidural / methods*
Anesthesia, General / methods*
Anesthetics, Local / administration & dosage
Bladder Exstrophy / surgery*
Bupivacaine / administration & dosage
Catheterization, Central Venous
Diazepam / administration & dosage
Female
Humans
Infant, Newborn
Lidocaine / administration & dosage
Male
Pain, Postoperative / drug therapy
Perioperative Care
Reconstructive Surgical Procedures
Retrospective Studies
Urologic Surgical Procedures
Chemical
Reg. No./Substance:
0/Adjuvants, Anesthesia; 0/Anesthetics, Local; 137-58-6/Lidocaine; 2180-92-9/Bupivacaine; 439-14-5/Diazepam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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