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Gastroschisis reduction under analgesia in the neonatal unit
R M Kimble1, S J Singh, C Bourke
1Department of Academic Surgery, The Children's Hospital at Westmead, Westmead Locked Bag 4001, Sydney, NSW 2145, Australia.
Purpose:
The authors present their experience of reduction of gastroschisis in infants in the ward with analgesia and without anesthesia.
Methods:
Prospective data were collected on 35 infants born with gastroschisis from 1999 to 2001. Ward reduction (WR) was not attempted in infants with obvious gut atresia, perforated or ischemic bowel, or systemic instability.
Results:
Ward reduction was attempted in 29 of the 35 infants and was successful in 25. There were no deaths or major morbidity in those that underwent ward reduction. Ventilation was required in 2, and line sepsis occurred in 4. Umbilical hernia was seen in 7; all but 1 were treated conservatively.
Conclusions:
In gastroschisis, ward reduction under analgesia is safe if strict selection criteria are adhered to. Postreduction ventilation is avoided in the majority.
