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2019

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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EPIDURAL BLOCK FOR TREATMENT OF FEMORAL ARTERY OCCLUSION AFTER ITS CANNULATION IN A NEWBORN PATIENT

Bárbara Ribeiro1, Pedro Freire2, Teresa Rocha3.

1 - Serviço de Anestesiologia, Centro Hospitalar de Setúbal, E.P.E.,
2 - Serviço de Anestesiologia, Centro Hospitalar de Lisboa Ocidental, E.P.E.;
3 - Serviço de Anestesiologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, E.P.E.

- Annual congress of the European Society for Paediatric Anaesthesiology Stresa, Itália (Comunicação Livre).

Introduction: Peripheral arterial cannulation in small children can be difficult and catheter-related complications are common; for these reasons, femoral artery cannulation is frequently performed.(1)
According to clinical criteria, the incidence of femoral artery complications (ischemia, thrombosis, embolism and infection) after cannulation in children is between 0,1-14%.(2)
The majority of clinically detected complications resolved immediately after catheter removal, with no long-term consequences, however there are a few case reports of other complications after femoral artery cannulation, such as femoral artery thrombosis necessitating thrombectomy and causing tissue loss. In this matter, echography is a good diagnostic procedure that can guide the therapeutic approach.(1)(2)
Some authors have identified neonatal status, age younger than 5 years and weight less than 10Kg as predictors of femoral artery complications.(2)

Case report: We describe a case of femoral artery occlusion after its cannulation in a newborn with all the predictors above. For treatment we chose a bolus of Ropivacaine 0,5% through caudal epidural and the removal of femoral catheter. Four hours later the situation worsened, and a new anaesthetic bolus on the caudal catheter solve the situation.

Conclusion: The simpatectomy caused by epidural block is a good option for treatment of arterial occlusion after femoral cannulation.

Keywords: epidural block, artery occlusion, cannulation, newborn.