| Perioperative anesthetic and analgesic management of newborn bladder exstrophy repair. | |
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MedLine Citation:
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PMID: 18644530 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Sabine Kost-Byerly; Eric V Jackson; Myron Yaster; Lori J Kozlowski; Ranjiv I Mathews; John P Gearhart |
Publication Detail:
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Type: Journal Article Date: 2008-04-01 |
Journal Detail:
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Title: Journal of pediatric urology Volume: 4 ISSN: 1873-4898 ISO Abbreviation: - Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-22 Completed Date: 2008-10-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101233150 Medline TA: J Pediatr Urol Country: England |
Other Details:
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Languages: eng Pagination: 280-5 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, the Johns Hopkins Hospital, Johns Hopkins University, School of Medicine, Baltimore, MD 21287, USA. skostby1@jhmi.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adjuvants, Anesthesia
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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:
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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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