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Revista Brasileira de Anestesiologia

Print version ISSN 0034-7094


GOUVEA, Paulo Antônio de Mattos  and  BERNARDES, Cassiano Franco. Combined anesthesia and early extubation in patient with patent ductus arteriosus: case report. Rev. Bras. Anestesiol. [online]. 2001, vol.51, n.4, pp.331-334. ISSN 0034-7094.

BACKGROUND AND OBJECTIVES: The ductus arteriosus is a structure of fetal circulation. Prematurity, hypoxia, acidosis and sepsis contribute for patent ductus arteriosus (PDA). This case report aimed at evaluating the use of combined regional/general anesthesia for surgical PDA repair. CASE REPORT: Male patient, 14 months of age, 11 kg, physical status ASA II, with repeated respiratory infections, was submitted to surgical PDA repair. Patient was premedicated with oral 0.5 midazolam followed by inhalational induction with 1-2% halothane. Hydration consisted of 8 lactated Ringer’s. After tracheal intubation, mechanical ventilation was installed with a pediatric closed system with CO2 absorber. Epidural puncture was performed at T1-T2 interspace, followed by a bolus injection of 0.5 of 0.125% bupivacaine with epinephrine 1:800,000. Anesthesia was maintained with halothane (0.5-0.6 CAM). The surgery lasted 70 minutes and was performed by latero-posterior thoracotomy, with good hemodynamic stability. The child was extubated in the operating room and sent to PACU in good conditions. CONCLUSIONS: Combined regional/general anesthesia in pediatric patients improves peri and postoperative analgesia. Thoracic epidural blockade can be used with good results, if carefully indicated.

Keywords : ANESTHESIA [Pediatric]; ANESTHETIC TECHNIQUES, Regional [toracic epidural block]; SURGERY, Cardiac [patent ductus arteriosus].

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