Perioperative care of infants with pyloric stenosis

Summary Pyloric stenosis (PS) is one of the most common surgical conditions affecting neonates and young infants. The definitive treatment for PS is surgical pyloromyotomy, either open or laparoscopic. However, surgical intervention should never be considered urgent or emergent. More importantly, em...

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Bibliographic Details
Published in:Pediatric anesthesia 2015-12, Vol.25 (12), p.1193-1206
Main Authors: Kamata, Mineto, Cartabuke, Richard S., Tobias, Joseph D.
Format: Article
Language:English
Subjects:
airway management
Anesthesia - methods
Humans
Infant
Infant, Newborn
neonatal anesthesia
Pain management
Pain, Postoperative - therapy
Perioperative Care - methods
pyloric stenosis
Pyloric Stenosis - surgery
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Summary:Summary Pyloric stenosis (PS) is one of the most common surgical conditions affecting neonates and young infants. The definitive treatment for PS is surgical pyloromyotomy, either open or laparoscopic. However, surgical intervention should never be considered urgent or emergent. More importantly, emergent medical intervention may be required to correct intravascular volume depletion and electrolyte disturbances. Given advancements in surgical and perioperative care, morbidity and mortality from PS should be limited. However, either may occur related to poor preoperative resuscitation, anesthetic management difficulties, or postoperative complications. The following manuscript reviews the current evidence‐based medicine regarding the perioperative care of infants with PS with focus on the preoperative assessment and correction of metabolic abnormalities, intraoperative care including airway management (particularly debate related to rapid sequence intubation), maintenance anesthetic techniques, and techniques for postoperative pain management. Additionally, reports of applications of regional anesthesia for either postoperative pain control or as an alternative to general anesthesia are discussed. Management recommendations are provided whenever possible.
ISSN:1155-5645
1460-9592
DOI:10.1111/pan.12792