Anesthesia and pain management in a pediatric patient with patent ductus arteriosus undergoing repair of recurrent diaphragmatic hernia

Abstract

Congenital diaphragmatic hernia is caused by a defect in the closure of the pericardio-peritoneal canal. It is a real challenge for the anesthetists during the perioperative management as serious complications including hypoxia and hypercarbia may threaten the life of the child. Mortality remains high due to associated pulmonary hypoplasia and pulmonary hypertension.

We present a case of a 15-month-old boy, known patient of recurrent congenital diaphragmatic hernia, scheduled to undergo laparotomy to repair his diaphragmatic defect. The patient presented with shortness of breath, and his chest X-ray revealed a diaphragmatic hernia. He was in optimal condition. General anesthesia was chosen with intubation. The patient remained stable and his laboratory tests were within normal limits. We discuss the associated problems during anesthesia and the optimum perioperative management.

Abbreviations: CDH - congenital diaphragmatic hernia; ECMO - Extracorporeal membrane oxygenation; ETT - Endotracheal tube

Key words: congenital diaphragmatic hernia, hypoxia, pulmonary hypoplasia

Citation: Sudjud RW, Tavianto D, Rismawan B, Ramila HN, Kurniawan MB, Annasya A. Anesthesia and pain management in a pediatric patient with patent ductus arteriosus undergoing repair of recurrent diaphragmatic hernia. Anaesth. pain intensive care 2023;27(2):280−284; DOI: 10.35975/apic.v27i2.2177

Received: August 28, 2022; Reviewed: November 05, 2022; Accepted: December 10, 2022