[Anesthetic management for a radical operation in an infant with cloacal exstrophy].
We report the anesthetic management for a radical operation in an infant with cloacal exstrophy. Diagnosis of cloacal exstrophy with meningocele was made at the 26th week of gestation. Cesarian section was performed under general anesthesia in order to keep the infant in a state of apnea to prevent aerophagia, the so-called "sleeping baby", at the 38th week of gestation. As soon as the infant was born, she was intubated orotracheally and a radical operation (abdominal closure, removal of meningocele, and vesico-intestinal-pelvioplasty) was performed. Some complications occurred during the operation including hypotension, oliguria, hypothermia, hypoproteinemia, hyponatremia and hyperpotassemia. The operation time was 10 hours and 30 minutes. Mechanical ventilation was continued for 4 days in the NICU and the infant was discharged 37 days after the operation. Early prenatal diagnosis and simulation of the operation enabled an effective surgical procedure allowing us to minimize these intraoperative complications.
Uruno
Shuichi
S
Department of Anesthesiology, Nikko Memorial Hospital, Muroran 051-0005.
Niiya
Tomohisa
T
Shichinohe
Yasuo
Y
Hazama
Kohji
K
Tsunoda
Kazumasa
K
D000015:Abnormalities, Multiple / Q000601:surgery*; D000328:Adult; D000334:Aerophagy / Q000517:prevention & control; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000773:Anesthesia, Obstetrical; D001006:Anus, Imperforate / Q000175:diagnosis / Q000601:surgery; D001049:Apnea; D001746:Bladder Exstrophy / Q000175:diagnosis / Q000601:surgery; D002585:Cesarean Section; D002988:Cloaca / Q000002:abnormalities* / Q000601:surgery*; D004065:Digestive System Abnormalities / Q000175:diagnosis / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008588:Meningocele / Q000175:diagnosis / Q000601:surgery; D011247:Pregnancy; D011296:Prenatal Diagnosis; D013520:Urologic Surgical Procedures