[Anesthetic management for the correction of pectus excavatum using pectus bar under video-assistance].
We report anesthetic management for a child undergoing Nuss operation, a minimally invasive operation which requires neither cartilage incision nor its resection for correction of pectus excavatum. The patient was a 7-year-old boy with the funnel index 5 and the mediastinal shift to the left. General anesthesia with endotracheal intubation was induced and maintained with nitrous oxide, sevoflurane and fentanyl. Thoracic epidural anesthesia was used with 0.125% bupivacaine to supplement analgesia. When the curved bar was passed under the sternum with the aid of an endoscope, sinus tachycardia occurred and continued for 5 minutes but subsided without medication. Otherwise operative course was uneventful with negligible blood loss. After surgery, the patient was kept at bed rest for 2 days, receiving epidural patient-controlled analgesia combined with sedation with midazolam with good results. He was allowed to sit 3 days, to walk 5 days and discharged 10 days postoperatively.
Fukunaga
T
T
Department of Anesthesiology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi 594-1101.
Kitamura
S
S
Kinouchi
K
K
Fukumitsu
K
K
Taniguchi
A
A
D016058:Analgesia, Patient-Controlled; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D002648:Child; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D019990:Perioperative Care; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*