RESUMO
We present a case of Freeman Sheldon (Whistling Face) syndrome. The anaesthetic management of an additional cervical kyphoscoliosis is discussed.
Assuntos
Anormalidades Múltiplas , Anestesia/métodos , Cifose , Microstomia , Palato/anormalidades , Escoliose , Criança , Humanos , Masculino , Procedimentos Cirúrgicos Operatórios , SíndromeRESUMO
Maxillary hypoplasia can pose considerable anaesthetic problems in securing the airway. The presence of concomitant, unsuspected choanal stenosis complicated the anaesthetic management of a 20-day-old baby for tarsorrhaphy.
Assuntos
Atresia das Cóanas/complicações , Maxila/anormalidades , Obstrução das Vias Respiratórias/etiologia , Anestesia por Inalação/efeitos adversos , Anestesia por Inalação/instrumentação , Fissura Palatina/complicações , Exoftalmia/complicações , Exoftalmia/cirurgia , Pálpebras/cirurgia , Humanos , Recém-Nascido , Mandíbula/anormalidadesRESUMO
Regional anaesthesia and analgesia offer unique advantages of reduction in general anaesthesia requirements and the demands on NICU resources while improving the general outcome. We assessed the feasibility of continuous lumbar epidural analgesia in 20 neonates for various major surgical procedures lasting from 60-260 min. The babies were aged 18 h to 34 days. They were born at a gestational age of 31-40 weeks. We had difficulty in passing the epidural catheter from the lumbar route in two patients, so we had to resort to the caudal route. The problems associated with the placement of the catheter from the lumbar route are discussed. The analgesia was provided for up to 72 h. Nineteen of the babies could be extubated in the operating theatre. They were awake but comfortable at the time of extubation. There were no complications due to the technique. Subsequent to this study, epidural analgesia either by lumbar or caudal route has become the routine in our hospital for all major thoraco-abdominal surgical procedures in neonates.