Anaesthetic management of a neonate with congenital cyst adenoid malformation.
We report the anaesthetic management of a male neonate with congenital cyst adenoid malformation (CCAM) of the lung who underwent thoracotomy for resection of CCAM 24 h after birth and again at 24 days. The initial operation involved a 10-day admission to a paediatric intensive care unit (PICU) requiring ventilation, and was complicated by a pneumothorax. This report concentrates on the anaesthetic management for the second thoracotomy. The combination of intra-operative remifentanil infusion and the use of ultrasound to confirm correct placement of epidural catheter allowed on-table tracheal extubation and a shorter stay in PICU. The use of one-lung ventilation (OLV) allowed for better surgical access and enabled complete resection of the lesion.
Guruswamy
V
V
Jackson Rees Department of Anaesthesia, The Royal Liverpool Children's Hospital NHS Trust, Alder Hey, Eaton Road, Liverpool L12 2AP, UK. umavelu18@aol.com
Roberts
S
S
Arnold
P
P
Potter
F
F
D000767:Anesthesia, Epidural; D018686:Anesthetics, Intravenous; D002404:Catheterization; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008168:Lung / Q000601:surgery*; D008297:Male; D010880:Piperidines; D000077208:Remifentanil; D012086:Reoperation; D013908:Thoracotomy; D014463:Ultrasonography
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil