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[Gastroschisis repair under caudal anesthesia: a series of three cases]
Neha Kasat1, Nandini Dave1, Harick Shah1
1Seth G.S. Medical College & K.E.M. Hospital, Department of Anesthesia, Mumbai, Índia.
Insights
Gastroschisis repair in neonates can be performed using caudal anesthesia alone, avoiding general anesthesia. This approach offers a potentially safer alternative for these high-risk infants.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Neonatal Care
Background:
- Gastroschisis is a congenital abdominal wall defect with high perioperative mortality.
- Current standard treatment involves general anesthesia, intubation, and mechanical ventilation.
- This necessitates intensive care unit admission post-surgery.
Observation:
- A series of three neonates with gastroschisis were treated.
- The surgical repair was performed exclusively under caudal anesthesia.
- No general anesthesia or endotracheal intubation was required.
Findings:
- Caudal anesthesia alone was successfully utilized for gastroschisis repair in three neonates.
- This approach eliminated the need for general anesthesia and postoperative mechanical ventilation.
- Perioperative outcomes were favorable in this small case series.
Implications:
- Caudal anesthesia may be a viable and potentially safer alternative for gastroschisis repair.
- This technique could reduce the need for intensive care and mechanical ventilation in neonates.
- Further research is warranted to validate these findings in larger cohorts.
Abstract:
Gastroschisis is a congenital anomaly characterized by a defect in the anterior abdominal wall with protrusion of abdominal viscera. Perioperative mortality is very high in these patients. Traditionally gastroschisis repair has been performed under general anesthesia with endotracheal intubation, requiring postoperative intensive care admission and mechanical ventilation. Caudal block is an attractive alternative to general anesthesia. We present a series of three neonates with gastroschisis, repaired solely under caudal anesthesia.