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Canadian Journal of Anesthesia, Vol 44, 666-668, Copyright © 1997 by Canadian Anesthesiologists' Society

ARTICLES

Epidural anaesthesia for ureteral reimplantation in an infant with congenital tracheal stenosis

M Concha, J Gonzalez, A Gonzalez, J Dagnino and R Molina
Department of Anaesthesiology, Catholic University of Chile, Santiago, Chile.

PURPOSE: We report a case of an infant with severe congenital tracheal stenosis who underwent ureteral reimplantation using lumbar epidural anaesthesia combined with light general anaesthesia. CLINICAL FEATURES: A six-month-old girl with symptomatic tracheal stenosis, demonstrated by computed tomography, was scheduled for ureteral reimplantation. She received continuous lumbar epidural anaesthesia with bupivacaine 0.25% through a 21 gauge catheter positioned at L3-4 interspace. Nitrous oxide/oxygen 50% and sevoflurane 1.5-2% were administered through a face mask and spontaneous breathing was preserved. Anaesthesia and surgery were uneventful. Postoperative epidural analgesia with bupivacaine 0.2% was excellent. The epidural catheter was withdrawn 48 hr postoperatively and she was discharged from the hospital five days later. CONCLUSION: Airway management is a major anaesthetic consideration in an infant with tracheal stenoses requiring abdominal surgery. We have demonstrated that regional anaesthesia combined with light general anaesthesia via face mask is an acceptable option, providing good analgesia during and after surgery. The technique preserves spontaneous ventilation and avoids tracheal manipulation.


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L. Vas, S. Sanzgiri, B. Patil, and V. Sanghvi
An unusual cause of tracheal stenosis
Can J Anesth, March 1, 2000; 47(3): 261 - 264.
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Copyright © 1997 by the Canadian Anesthesiologists' Society.