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Respiratory Depression after Caudal Anesthesia for a Case Operated Owing to Sipina Bifida

Year 2007, Volume: 14 Issue: 4, 271 - 273, 01.08.2007

Abstract

The aim of this case report is to discuss the respiratory depression after caudal anesthesia for a case operated previously owing to spina bifida. Neural tube defects are malformations of central nervous system of which spina bifida is the most common. This group is characterized by the protrusion of the meninges and-or the spinal cord through open vertebral arches. Spina bifida can be treated with orthotic treatment, physical therapy or surgical treatment. A 9400 -gr-, 11 month old baby to be operated owing to inguinal hernia was administered caudal anesthesia with bupivacaine, %0,25 at 1 ml.kg-1 , after 1 mg midazolam and 25 mg propofol administration intravenously. Respiratory depression occurred 25 min after caudal anesthesia. Endotracheal entubation was administered and the case was ventilated mechanically. The case was extubated 145 min after caudal anesthesia, first tobe taken to the recovery room, second tobe taken to pediatric surgery unit and discharged from hospital at 2 days following surgery. The use of low volume local anesthetic could decrease the complications in and patients. Key words: Caudal anesthesia, Spina bifida.

References

  • Padmanabhan R. Etiology, pathogenesis and prevention of neural tube defects. Congenit Anomal 2006; 46: 55-67.
  • MacKenzie TC, Adzick NS. Advances in fetal surgery. J İntensive Care Med 2001; 16: 251-62.
  • Northrup H, Volcik A. Spina bifida and other neural tube defects. Curr Probl Pediatr 2000; 30: 313-32
  • Bartonek Å, Saraste H, Knutson LM. Comparison of different systems to classify the neurological level of lesion in patients with myelomeningocele. Dev Med Child Neurol 1999; 41: 796-805.
  • Della CF, Frank P, Pietrini D, et al. Anesthesia in the early surgical therapy of myelomeningocele. Pediatr Med Chir 1984; 6:553-6
  • Viscomi CM, Abajian JC, Wald SL, et al. Spinal anesthesia for repair of meningomyelocele in neonates. Anesth Analg 1995; 81: 492-5.
  • Kovarik WD. Upper airway obstruction and meningomyelocele. İn: Miller RD. Anesthesia, 5th edition, Philaldelphia, USA: Churchill Livingstone: 2000; 2467.
  • Schuepfer G, Konrad C, Schmeck J, Poortmans G, Staffelbach B Johr M. Generating a learning curve for pediatric caudal epidural blocks: An empirical evaluation of technical skills in novice and experienced anesthetists. Reg Anesth Pain Med 2000; 25: 385-8.
  • Silvani P, Camporesi A, Agostino MR, Salvo I. Caudal anesthesia in pediatrics: An update. Minerva Anestesiol 2006; 72: 453-9.
  • Conceicao MJ, L Coelhoc. Caudal anaesthesia with 0.375% ropivacaine or 0.375% bupivacaine in paediatric patients. Br J Anaesth 1998; 80: 507-8
  • Khalil S, Campos C, Farag AM, Vve H, Ritchey M, Chuang A. Caudal bbck in children ropivacaine compared with bupivacaine. Anesthesiology 1999; 91: 1279-84
  • Tuncer S, Yosunkaya A, Reıslı R, Tavlan A, Cıcekcı F, Otelcıoglu S. Effect of caudal block on stress responses in children. Pediatr Int 2004; 46: 53-7
  • Hansen TG, Morton NS, Cullen PM, Watson DG. Plasma concentrations and pharmacokinetics of bupivacaine with and without adrenaline following caudal anaesthesia in infants. Acta Anaesthesiol Scand 2001; 45: 42-7
  • Verghese ST, Hannallah RS, Rice LJ, Belman AB, Patel KM. Caudal anesthesia in children: Effect of volume versus concentration of bupivacaine on blocking spermatic cord traction response during orchidopexy. Anesth Analg 2002; 95: 1219-23
  • Nielsen LAG, Maroun LL, Broholm H, Laursen H, Graem N. Neural tube defects and associated anomalies in a fetal and perinatal autopsy series. APMIS 2006; 114: 239-46.
  • Bare A, Vankoski SJ, Dias L, et al. Independent ambulators with high sacral myelomeningocele the relation between walking kinematics and energy consumption. Dev Med Child Neurol. 2001; 43: 16-21.

Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu

Year 2007, Volume: 14 Issue: 4, 271 - 273, 01.08.2007

Abstract

Bu olgu sunumunda sipina bifida nedeniyle operasyon geçirmiş bir olguda kaudal anestezi sonrası meydana gelen solunum depresyonunun tartışılması amaçlandı. Nöral tüp defektleri santral sinir sistemi malformasyonlarındandır. Spina bifida en sık görülen gruptur. Bu grup nöral tüp defekti meninkslerin ve-veya spinal kordun, açık olan vertebral arktan dışarıya doğru çıkmaları ile karakterizedir. Spina bifida ortotik tedavi, fizik tedavi veya cerrahi ile düzeltilebilmektedir. 11 aylık 9400 gram bir ağırlığında inguinal herni operasyonu yapılacak erkek bebeğe i.v. 1 mg midazolam ve toplam 25 mg propofol verildikten sonra kaudal epidural aralığa %0,25'lik bupivakainden 1 ml.kg-1 uygulandı. Kaudal anesteziden 25 dk sonra hastada solunum depresyonu meydana geldi. Olguya endotrakeal entübasyon yapılarak mekanik ventilatöre bağlandı. Kaudal anesteziden 145 dk sonra ekstübe edilerek ayılma odasına, daha sonra servise, 2 gün sonra da servisten evine taburcu edildi. Bu hastalarda daha düşük volümde lokal anestezik kullanımı komplikasyonları azaltacaktır. Anahtar kelimeler: Kaudal anestezi, Spina bifida.

References

  • Padmanabhan R. Etiology, pathogenesis and prevention of neural tube defects. Congenit Anomal 2006; 46: 55-67.
  • MacKenzie TC, Adzick NS. Advances in fetal surgery. J İntensive Care Med 2001; 16: 251-62.
  • Northrup H, Volcik A. Spina bifida and other neural tube defects. Curr Probl Pediatr 2000; 30: 313-32
  • Bartonek Å, Saraste H, Knutson LM. Comparison of different systems to classify the neurological level of lesion in patients with myelomeningocele. Dev Med Child Neurol 1999; 41: 796-805.
  • Della CF, Frank P, Pietrini D, et al. Anesthesia in the early surgical therapy of myelomeningocele. Pediatr Med Chir 1984; 6:553-6
  • Viscomi CM, Abajian JC, Wald SL, et al. Spinal anesthesia for repair of meningomyelocele in neonates. Anesth Analg 1995; 81: 492-5.
  • Kovarik WD. Upper airway obstruction and meningomyelocele. İn: Miller RD. Anesthesia, 5th edition, Philaldelphia, USA: Churchill Livingstone: 2000; 2467.
  • Schuepfer G, Konrad C, Schmeck J, Poortmans G, Staffelbach B Johr M. Generating a learning curve for pediatric caudal epidural blocks: An empirical evaluation of technical skills in novice and experienced anesthetists. Reg Anesth Pain Med 2000; 25: 385-8.
  • Silvani P, Camporesi A, Agostino MR, Salvo I. Caudal anesthesia in pediatrics: An update. Minerva Anestesiol 2006; 72: 453-9.
  • Conceicao MJ, L Coelhoc. Caudal anaesthesia with 0.375% ropivacaine or 0.375% bupivacaine in paediatric patients. Br J Anaesth 1998; 80: 507-8
  • Khalil S, Campos C, Farag AM, Vve H, Ritchey M, Chuang A. Caudal bbck in children ropivacaine compared with bupivacaine. Anesthesiology 1999; 91: 1279-84
  • Tuncer S, Yosunkaya A, Reıslı R, Tavlan A, Cıcekcı F, Otelcıoglu S. Effect of caudal block on stress responses in children. Pediatr Int 2004; 46: 53-7
  • Hansen TG, Morton NS, Cullen PM, Watson DG. Plasma concentrations and pharmacokinetics of bupivacaine with and without adrenaline following caudal anaesthesia in infants. Acta Anaesthesiol Scand 2001; 45: 42-7
  • Verghese ST, Hannallah RS, Rice LJ, Belman AB, Patel KM. Caudal anesthesia in children: Effect of volume versus concentration of bupivacaine on blocking spermatic cord traction response during orchidopexy. Anesth Analg 2002; 95: 1219-23
  • Nielsen LAG, Maroun LL, Broholm H, Laursen H, Graem N. Neural tube defects and associated anomalies in a fetal and perinatal autopsy series. APMIS 2006; 114: 239-46.
  • Bare A, Vankoski SJ, Dias L, et al. Independent ambulators with high sacral myelomeningocele the relation between walking kinematics and energy consumption. Dev Med Child Neurol. 2001; 43: 16-21.
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Zafer Doğan This is me

Nedim Keleşyılmaz This is me

Publication Date August 1, 2007
Published in Issue Year 2007 Volume: 14 Issue: 4

Cite

APA Doğan, Z., & Keleşyılmaz, N. (2007). Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu. Journal of Turgut Ozal Medical Center, 14(4), 271-273.
AMA Doğan Z, Keleşyılmaz N. Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu. J Turgut Ozal Med Cent. August 2007;14(4):271-273.
Chicago Doğan, Zafer, and Nedim Keleşyılmaz. “Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu”. Journal of Turgut Ozal Medical Center 14, no. 4 (August 2007): 271-73.
EndNote Doğan Z, Keleşyılmaz N (August 1, 2007) Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu. Journal of Turgut Ozal Medical Center 14 4 271–273.
IEEE Z. Doğan and N. Keleşyılmaz, “Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu”, J Turgut Ozal Med Cent, vol. 14, no. 4, pp. 271–273, 2007.
ISNAD Doğan, Zafer - Keleşyılmaz, Nedim. “Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu”. Journal of Turgut Ozal Medical Center 14/4 (August 2007), 271-273.
JAMA Doğan Z, Keleşyılmaz N. Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu. J Turgut Ozal Med Cent. 2007;14:271–273.
MLA Doğan, Zafer and Nedim Keleşyılmaz. “Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu”. Journal of Turgut Ozal Medical Center, vol. 14, no. 4, 2007, pp. 271-3.
Vancouver Doğan Z, Keleşyılmaz N. Spina Bifida Nedeniyle Operasyon Geçirmiş Bir Olguda Kaudal Anestezi Sonrası Solunum Depresyonu. J Turgut Ozal Med Cent. 2007;14(4):271-3.