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Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Central venous cutdown in neonates: feasibility as a bedside procedure without general anesthesia
Sung-Min Hong1, Hyeon-Soo Lee, Suk-Bae Moon
1Department of Surgery, Kangwon National University Hospital, Chuncheon, South Korea.
Journal of Pediatric Surgery
|August 13, 2013
Summary
Open surgical cutdown (OSC) for central venous catheter (CVC) insertion in neonates is feasible without general anesthesia. This method uses sedation and local anesthesia, avoiding the adverse effects of general anesthesia in this vulnerable population.
Area of Science:
- Neonatal Surgery
- Pediatric Anesthesiology
- Vascular Access
Background:
- Central venous catheter (CVC) insertion typically uses percutaneous techniques under general anesthesia.
- General anesthesia poses significant postoperative risks for neonates.
Purpose of the Study:
- To evaluate the feasibility of open surgical cutdown (OSC) for neonatal central venous access without general anesthesia.
Main Methods:
- Retrospective review of medical records for neonates undergoing OSC under sedation and local anesthesia.
- Sedation induced with chloral hydrate and lidocaine infiltration; phenobarbital used for inadequate sedation.
Main Results:
- Thirteen Broviac lines inserted in 12 neonates (median gestational age 29 weeks, birth weight 1,140 g).
- No invasive ventilation, intubation, or inotropes required; no perioperative surgical complications.
- Median catheter duration was 19.5 days.
Conclusions:
- Open surgical cutdown at the bedside for CVC insertion is a feasible procedure in neonates.
- Utilizing adequate sedation and local anesthesia avoids general anesthesia complications.
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