title: Neonatal limb ischemia: caudal blockade and NIRS monitoring.
abstract: The treatment of neonatal limb ischemia (LI) is challenging for neonatologists. Peripheral nerve blockade (PNB), alone or in association with other therapies, represents a valid therapy in case of vascular spasm or thromboembolic events responsible for LI. In the present case report, we describe the clinical history of a preterm neonate with catheter-related thrombosis of the left leg. PNB was not performed according to the traditional technique but rather by a peridural catheter left in situ for 9 days with a continuous infusion of ropivacaine. In conclusion, the effectiveness of this approach was confirmed by the contemporary near-infrared spectroscopy monitoring, documenting gradual improvement of leg perfusion.
authors.affiliation: Department of Neonatology, Bambino Gesù Children's Hospital, Piazza S. Onofrio 4, 00165, Rome, Italy.
authors.forename: Fiammetta
authors.initials: F
authors.lastname: Piersigilli
authors.forename: Iliana
authors.initials: I
authors.lastname: Bersani
authors.forename: Paola
authors.initials: P
authors.lastname: Giliberti
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Ronchetti
authors.forename: Raul Laviani
authors.initials: RL
authors.lastname: Mancinelli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Cavadenti
authors.forename: Andrea
authors.initials: A
authors.lastname: Dotta
mesh_terms: D000577:Amides; D000763:Anesthesia, Caudal / Q000379:methods*; D000779:Anesthetics, Local; D002406:Catheterization, Peripheral / Q000009:adverse effects; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D009407:Nerve Block / Q000379:methods*; D000077212:Ropivacaine; D019265:Spectroscopy, Near-Infrared; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine