[Anesthetic management for a radical operation in an infant with cloacal exstrophy]

Area of Science:

• Pediatric Surgery
• Anesthesiology
• Neonatal Care

Background:

• Cloacal exstrophy with meningocele diagnosed prenatally at 26 weeks gestation.
• Radical surgical repair required immediate neonatal intervention.

Observation:

• Cesarean section under general anesthesia utilized the "sleeping baby" technique to prevent aerophagia.
• Infant was intubated immediately after birth for orotracheal intubation and subsequent radical operation.

Findings:

• The 10-hour, 30-minute operation involved abdominal closure, meningocele removal, and vesico-intestinal-pelvioplasty.
• Intraoperative complications included hypotension, oliguria, hypothermia, hypoproteinemia, hyponatremia, and hyperpotassemia.
• Postoperative mechanical ventilation lasted 4 days in the Neonatal Intensive Care Unit (NICU).

Implications:

• Early prenatal diagnosis and surgical simulation were crucial for effective management.
• This approach minimized intraoperative complications in a complex neonatal surgical case.
• The infant was discharged 37 days post-operation, highlighting successful multidisciplinary care.