Gastroschisis repair under caudal anesthesia: a series of three cases

Kasat, Neha; Dave, Nandini; Shah, Harick; Mahajan, Swapnil

doi:10.1016/j.bjane.2016.07.006

Cited by 3 publications

(6 citation statements)

References 5 publications

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“…Another concern about bedside Gastroschisis management is the significant stress response of neonate due to poor pain control and unstandardized suboptimal procedure environment (7,8). Regarding these concerns, several articles proposed primary closure under analgesia or caudal anesthesia (6,9).…”

Section: Discussionmentioning

confidence: 99%

Intra-Operative Total Bowel Washing: A New Method to Improve the Outcome of Gastroschisis Primary Repair

Mohammadipour¹,

Hiradfar²,

Shojaeian³

2020

Iran J Pediatr

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Background: Gastroschisis is an abdominal wall defect that is managed by surgical reduction of herniated bowel into the abdominal cavity and abdominal wall reconstruction. Loss of abdominal domain is the main challenge that may complicate the process of gastroschisis management. Objectives: This article is about innovative manure called total bowel washing (TBW) that may improve the outcome of gastroschisis primary repair. Methods: All neonates with gastroschisis who met the study inclusion criteria between 2006 - 2019 were enrolled and divided into two groups of conventional and TBW method of gastroschisis management. In TBW group, bowls were washed with warm saline and after a gentle enterolysis, the whole gastrointestinal tract was irrigated via a gastric tube and evacuated completely from thick meconium until the watery stool started to come out of anus slightly. Primary abdominal wall closure was performed after loop by loop bowel reduction. Gastroschisis management outcome was compared between the two groups. Results: 15 neonates were allocated in each group. Demographic and anthropometric variables were compared and any significant difference wasn’t reported between the two groups. We observed a significantly better outcome in terms of faster GI rehabilitation, shorter time to oral feeding tolerance, less need to silo placement and shorter NICU and hospital stay in TBW method. Operation time was slightly longer in TBW group while the difference was not significant statistically. Conclusions: Total bowel washing and complete evacuation of gastrointestinal tract from thick meconium will increase the success rate of primary repair and improve the outcome of gastroschisis management.

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Section: Discussionmentioning

confidence: 99%

Intra-Operative Total Bowel Washing: A New Method to Improve the Outcome of Gastroschisis Primary Repair

Mohammadipour¹,

Hiradfar²,

Shojaeian³

2020

Iran J Pediatr

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“…Choice of anesthesia varies from conventional general anesthesia with opioids for analgesia, general anesthesia along with regional techniques like spinal block and combined spinal epidural catheters as sole anesthesia technique and use of caudal block only. 7,8 The result of study shows that time of intubation and need of postoperative ventilation is reduced in GA with regional blocks for analgesia as compared to GA with opioids and difference is statistically significant and our results were comparable with Murali Raghavan et al in 2008 they reviewed anesthetic management of gastroschisis and according to them traditional opioid analgesia when compared with regional technique may be associated with increased need for postoperative ventilation and general anesthesia without opioid and regional technique for analgesia is valid method for gastroschisis surgery. 9 Techniques practiced in our institute for gastroschisis repair are GA with opioids for analgesia, GA along with caudal block, spinal anesthesia only and our modified technique of general anesthesia in which neonates are intubated after deepening anesthesia with sevoflurane.…”

Section: Discussionmentioning

confidence: 99%

“…Our techniques matched with techniques used by other authors. 5,8,9 In neonates the organs are immature, so drugs that depend on hepatic clearance like sedatives, opioids, neuromuscular blocking agent have prolonged duration of action and need to be given in titration. By giving regional block along with GA we can avoid use of muscle relaxants and opioid.…”

Section: Discussionmentioning

confidence: 99%

“…Neha Kasat et al in 2017 successfully used combination of 0.5% bupivacaine (2mg/kg) and 2% lignocaine with adrenaline (1:200000) 7mg/kg in caudal block as sole anesthetic technique. 8 In this technique we can avoid opioids and decrease need for postoperative ventilation. It is technically easy, but apart from other problems there is risk of unprotected airway.…”

Section: Discussionmentioning

confidence: 99%

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Anaesthetic considerations in gastroschisis repair at a tertiary care hospital

Kundal

Dogra

Kundal

2019

Sri Lankan J Anaesthesiol

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Gastroschisis is congenital anomaly characterized by a defect in the anterior abdominal wall with evisceration of abdominal contents. Choice of anaesthesia for its repair varies from conventional general anaesthesia with opioids for analgesia, general anaesthesia along with regional techniques like spinal and caudal blocks or sole regional anaesthesia. Aims: To retrospectively analyze various techniques used for anaesthetic management of gastroschisis repair surgery in our institute and compare outcome of patients in terms of extubation time and requirement of postoperative mechanical ventilation. Material and Methods: Eighty-two cases operated for gastroschisis in our hospital over a period of four years were retrospectively analyzed in terms of age, sex, gestation, type of surgical procedure and anaesthesia techniques. Time of extubation and requirement of postoperative mechanical ventilation was compared between general anaesthesia and regional anesthesia group. Results: Seventy-two cases were included in study with 28 patients in general anaesthesia group and 44 patients in regional group. Out of 14 term neonates 2 needed post-operative ventilation in regional group. 6 out of 10 term neonates needed postoperative ventilation in opioid group. Among preterm neonates 12 out of 30 needed post-operative ventilation in regional group and all 18 needed postoperative ventilation in opioid group. In both term as well as preterm patients, regional group had faster extubation rate and lesser need of postoperative ventilation when compared to general anaesthesia group. Difference was statistically significant. Conclusion: We conclude that use of regional blocks along with general anaesthesia is safe and effective for management of neonates with gastroschisis presenting for primary repair.

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“…O auxílio da música melhorou o prognostico dos pacientes. Kasat et al, 2017 Gastroschisis repair under caudal anesthesia: a series of three cases…”

Section: Acta Anaesthesiol Scandunclassified

Anestesia neuroaxial comparada à anestesia geral para procedimentos na metade inferior do corpo

Bomfim

Behrens²,

Araújo³

et al. 2022

RSD

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A pesquisa objetiva avaliar a eficácia da anestesia neuroaxial em comparação com a anestesia geral para procedimentos na metade inferior do corpo. Trata-se de uma revisão integrativa da literatura realizada através das bases de dados Scientific Eletronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Medical Literature Analysis and Retrieval System Online (MEDLINE), através dos seguintes Descritores em Ciências da Saúde (DeCS): “Anestesia Geral” e “Anestesia Caudal”. Combinados entre si pelo operador boleando AND. Como critérios de inclusão: artigos disponíveis na integra, nos idiomas portuguêsn, inglês e espanhol, que abordassem a tematica, nos últimos cinco anos (2017-2022). Como citérios de exclusão: artigos que não contemplavam o tema e estudos repetidos nas bases de dados. A partir da busca inicial com os descritores e operador booleando definidos, foram encontrados 90 estudos nas bases selecionadas e após aplicar os critérios de inclusão foram selecionados 7 estudos para compor a amostra final. Diante do exposto, podemos perceber que o bloqueio neuroaxial é superior a anestesia geral tendo em vista maior custo benefício, menores complicações associadas.

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Gastroschisis repair under caudal anesthesia: a series of three cases

Cited by 3 publications

References 5 publications

Intra-Operative Total Bowel Washing: A New Method to Improve the Outcome of Gastroschisis Primary Repair

Intra-Operative Total Bowel Washing: A New Method to Improve the Outcome of Gastroschisis Primary Repair

Anaesthetic considerations in gastroschisis repair at a tertiary care hospital

Anestesia neuroaxial comparada à anestesia geral para procedimentos na metade inferior do corpo

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