Department of Pediatric Surgery, Selcuklu Medical Faculty, Selcuk University, Konya, Turkey.
J Pediatr Surg. 2012 Aug;47(8):e33-5. doi: 10.1016/j.jpedsurg.2012.03.085.
Duodenal atresia is a well-recognized cause of neonatal bowel obstruction. General anesthesia with tracheal intubation is the traditional anesthetic technique for surgical correction of this condition. Metabolic abnormalities and fluid deficits coupled with residual anesthetics are known to increase the risk of postoperative apnea, prolonging the operating room time and delaying extubation. Spinal anesthesia (SA) is an accepted alternative to general anesthesia in formerly preterm infants. In the current literature, there are reports of successful use of SA for simple infraumbilical surgery and, occasionally, for upper abdominal surgery, but there is no information on the use of SA in neonates for duodenal atresia repair. We present a case of duodenal atresia in a preterm infant at a gestational age of 30 weeks with coexisting bronchopulmonary dysplasia successfully repaired under SA. Further studies that compare the adverse effects with the potential advantages of SA are warranted before future recommendations are made for neonates who are undergoing upper abdominal surgery.
十二指肠闭锁是新生儿肠梗阻的一个公认原因。气管插管全身麻醉是手术矫正这种情况的传统麻醉技术。代谢异常和液体不足加上残留的麻醉剂会增加术后呼吸暂停的风险，延长手术室时间并延迟拔管。脊髓麻醉（SA）是对曾经早产婴儿进行全身麻醉的另一种可接受的替代方法。在当前的文献中，有报道称 SA 可成功用于简单的脐下手术，偶尔也可用于上腹部手术，但尚无关于 SA 在用于十二指肠闭锁修复的新生儿中的使用信息。我们报告了一例胎龄为 30 周的患有支气管肺发育不良的早产儿十二指肠闭锁的病例，该病例在 SA 下成功修复。在为接受上腹部手术的新生儿提出未来建议之前，需要进行进一步的研究，比较 SA 的不良反应和潜在优势。
