| Anesthetic Management for Repair of Congenital Diaphragmatic Hernia. |
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Sang Ha Lee, Jung Koo Lee, Byung Yon Kown |
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Department of Anesthesiology, Wallace Memorial Baptist Hospital, Pusan, Korea. |
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| Abstract |
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A 2600 gm term female baby was born through Caesarean section at Baptist Hospital to 29-year-old, primigravda woman who had pregnancy induced hypertension(PIH), HBsAg carrier, and chronic glomerulonephritis. Apgar scores were 5 at one minute and 7 at five minutes. There was extreme respiratory distress in the nursery and she was diagnosed as congenital diaphramatic hernia. At operation, there was a left sided foramen of Bochdalek hernia with hypoplasia of left lung. The diaphragmatic hernia was reduced and cardiac evaluation revealed no evidence of congenital heart disease (CHD) by clinical examination. There also noted no right to left shunt via patent ductus arteriosus. After operation, endotracheal tube was left in place and the patient returned to the nursery where she received respiratory care with infant ventilator. The major determinants of outcome in patients with CHD are the extent of pulmonary hypoplasia and the degree of pulmonary hypertension. So pre- and postoperative management of the pulmonary hypertension is as important as surgical correction of the CHD. The patient tolerated anesthesia and surgery well, and was discharged one month later. |
| Key Words:
Anesthesia; Pediatric; Congenital diaphragmaic hernia |
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