Document Detail


Spinal anesthesia for primary repair of gastroschisis: a new and safe technique for selected patients.
MedLine Citation:
PMID:  7807354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Spinal anesthesia has been described for infants and premature babies undergoing minor operative procedures. The advantages of shorter operating time, avoidance of intubation, and shorter hospital stay have made this the gold standard for premature and other high-risk infants requiring minor procedures. However, little is known about this technique for major interventions in newborns and preterm infants. Recently, four infants born with gastroschisis underwent repair under spinal anesthesia. Two had accompanying intestinal atresia (one with a prenatal perforation and pan-hypopituitarism), and two had intact gastrointestinal systems. The gestational ages were 39, 33, 36, and 36 weeks, respectively. All had primary closure of the defect; one had no repair of the atresia because the bowel was thick and matted with a significant peel, and the defect was not identified. In the second case with atresia, necrosis and perforation of a localized segment of intestine was identified proximal to the intestinal atresia, and was exteriorized with the primary repair. When they arrived in the operating room, all four infants were breathing spontaneously, on room air, after appropriate fluid resuscitation. All underwent spinal anesthesia, which was the only agent used for the operation. The operative time was 45, 25, 30, and 25 minutes, respectively (mean, 31.25 minutes). The duration of anesthesia was 170 to 230 minutes (mean, 205 minutes). All infants were returned to the neonatal intensive care unit on room air and breathing spontaneously. One was given morphine postoperatively and suffered significant respiratory depression, requiring intubation. It appears that spinal anesthesia is safe and effective for major operative procedures in high-risk infants. (ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
D W Vane; J C Abajian; A R Hong
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  29     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1995-02-02     Completed Date:  1995-02-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1234-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Vermont, College of Medicine, Burlington.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Muscles / abnormalities*,  surgery
Anastomosis, Surgical
Anesthesia, Spinal*
Female
Gestational Age
Humans
Infant, Newborn
Infant, Premature, Diseases / surgery*
Intestinal Atresia / surgery*
Intestinal Perforation / surgery
Male
Postoperative Complications / surgery
Reoperation
Respiration, Artificial
Tetracaine*
Chemical
Reg. No./Substance:
94-24-6/Tetracaine

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


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