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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. http://dx.doi.org/10.1590/S0034-70942001000400009.
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 mg.kg-1 midazolam followed by inhalational induction with 1-2% halothane. Hydration consisted of 8 ml.kg-1.h-1 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 ml.kg-1 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].