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Continuous caudal epidural blocade in postoperative analgesia of an extremely premature baby – case report


Authors: Mixa Vladimír 1;  Berka Ivan 2;  Rygl Michal 3
Authors place of work: Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice v Motole a 2. lékařská fakulta Univerzity Karlovy, Praha 1;  Oddělení pediatrie, Ústav pro péči o matku a dítě, Praha 2;  Klinika dětské chirurgie, Fakultní nemocnice v Motole a 2. lékařská fakulta Univerzity Karlovy, Praha 3
Published in the journal: Anest. intenziv. Med., 25, 2014, č. 3, s. 190-193
Category: Anaesthesiology - Case Report

Summary

This case report illustrates the use of continuous caudal epidural blockade in postoperative analgesia of an extremely premature baby. A patient with body weight of 550 g was treated for a severe form of necrotizing enterocolitis. Systemic analgesia was no longer sufficient, and therefore it was combined with continuous caudal epidural analgesia by a 1F (28G) catheter. Continuous levobupivacaine 0.25% was administered at 0.2 mg/kg/h. The quality of analgesia was evaluated by the Comfort Neo score with a satisfactory result.

Keywords:
continuous caudal analgesia – premature newborn – necrotizing enterocolitis – Comfort Neo Scale


Zdroje

1. Lonnqvist, P. A. Regional anaesthesia and analgesia in the neonate, Best Practice and Research Clinical Anaesthesiology, 2010, 24, p. 309–321.

2. Bosenberg, A. Regional anaesthesia in children: the future, Pediatric Anaesthesia, 2012, 22, p. 564–569.

3. Polaner, M. D., Drescher, J. Pediatric regional anesthesia: what is the current safety record? Pediatric Anaesthesia, 2011, 21, p. 737–742.

4. Mixa, V., Cvachovec, K., Rousková, B., Zítková, M. Kontinuální kaudální blok u dětí. Anest. neodkl. Péče, 13, 2002, 5, p. XVII–XX.

5. Neu, J., Walker, W. A. Necrotizing enterocolitis, N. Engl. J. Med., 2011, 364, p. 255–264.

6. Fitzgibbons, S. C., Ching, Z., Yu, D. et al. Mortality of necrotizing enterocolitis expressed by birth weight categories. J. Pediatr. Surg., 2009, 44, p. 1072–1076.

7. Van Dijk, M., Roofthooft, D. W. E., Anand, K. J. S., Guldemond, F., de Graf, J., Simons, S., de Jager, Y., van Goudoever, J. B., Tibboel, D. Taking Up the Challenge of Measuring Prolonged Pain in (Premature) Neonates. The Comfort Neo Scale Seems Promising. Clin. J. Pain., 2009, 25, p. 607–616.

Štítky
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
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