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2019

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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ANAL ATRESIA ANESTHETIC MANAGEMENT: 1 DAY OLD NEONATE CASE REPORT

Rodrigues, Nuno (1); Mer, Stephanie (1); Oliveira Maria Inês (1); Figueiredo, Joana (2); Rocha, Teresa (2).

(1) Serviço de Anestesiologia, Centro Hospital de Lisboa Ocidental
(2) Serviço de Anestesiologia, Centro Hospital de Lisboa Central

Locais de apresentação e publicação

ESPA – European Society for Paediatric Anaesthesiology Belgrado 2016 (Poster)

Introdução: Intestinal atresia is one of the major causes of neonatal intestinal obstruction. During the past decades a better understanding of the etiology and improvement in anesthesiology and perioperative care led to a significant improvement in survival.
Discussion: The ultrasound guided regional techniques had a tremendous development in recent years, which has allowed new approaches to “old” diseases. Despite promising anesthetic outcomes, more cases and studies are needed to achieve gold standard approaches.
Caso Clinico: A one day old boy was diagnosed with anal atresia in the delivery room. He was referred to our hospital with three hours of live. There were no other malformations. He was purposed for an emergency colostomy. In the operating room we made an inhalational induction with sevoflurane. After the endotracheal intubation (with previous administration of propofol and alfentanil) we made a continuous caudal block guided by ultrasound. A bolus of ropivacaine were administrated before the beginning of the surgery. In the intraoperative course the child have been hemodynamically stable. No additional drugs were given for intraoperative analgesia. At the end of the surgery we initiate a perfusion with ropivacaine for the postoperative analgesia. He was extubated fifteen hours after surgery in the intensive care unit, where he stayed for three days. The remainder hospital stay was uneventful.
Discussão: The ultrasound guided regional techniques had a tremendous development in recent years, which has allowed new approaches to “old” diseases. Despite promising anesthetic outcomes, more cases and studies are needed to achieve gold standard approaches.