Anaesthetic Challenges & Management of Myelomeningocele Repair

Authors

  • Dr. Shashank Mohole
  • Dr. Harish Jadhav
  • Dr. Sunil Natha Mhaske

DOI:

https://doi.org/10.46858/dvvpf.j.

Keywords:

Myelomeningocele, Meningomyelocele, Spina bifida, Hydrocephalus, General anaesthesia

Abstract

Myelomeningocele (meningomyelocele (MMC) or spina bifida) is a form of neural tube defect. Failure of neural tube closure early in intrauterine development results in spectrum of abnormalities ranging from spina bifida occulta, a relatively benign condition to meningomyelocele, an abnormality involving vertebral bodies, spinal cord and brainstem. These babies also have associated congenital anomalies like intestinal malrotation, renal anomalies, cardiac malformations and tracheoesophageal fistula. Anaesthesia for meningomyelocele always poses a challenge to anaesthesiologist as one has to deal with neonates and infants who already have so many anatomical and physiological differences compare to the adults or normal children. Methodology: To identify the anaesthetic challenges/ complications during perioperative and postoperative myelomeningocele repair. It was a retrospective study has been carried out on 20 children having age less than 2 year, operated during 1st July 2018 to 1st June 2019 at tertiary care hospital, Ahmednagar. Results: Overall complications were seen in 64.9% and the most common complications were respiratory like laryngospasm, bronchospasm, and hypoxemia and endobronchial intubation. Most of the complications were manageable through early and precise diagnosis. Conclusion: Children with meningomyelocele are prone to have peri-operative complications, hence Meticulous anaesthetic management is crucial for early repair and to prevent sequele of meningomyelocele.

Downloads

Download data is not yet available.

References

Bunch WH, WH green, St. Louis PP. Modern management of mylomeningocele 1972; 168-174.

AM Adzick NS Fetal myelomeningocele. Naturalhistory, pathophysiology, and in-utero intervention. Semin Fetal Neonatal Med 2010; 15:9–14.

McLone DG, Knepper PA. The cause of ChiariII malformation: a unified theory. J PediatrNeurosci 1989;15: 1–12.

Gok HB, Ayberk G, Tosun H, Seckin Z. Clinical course and evaluation of meningocele lesion in adulthood: A case report. Neuroanatomy. 2005;4:52–4.

Stephen A. Back, in Avery's Diseases of the Newborn (Eighth Edition), 2005.

Mowatt DJ, Thomson DN, Dunaway DJ. Tissue expansion for the delayed closure of large myelomeningoceles. J Neurosurg. 2005;103:544–8.

Raimondi ACM, Di Rocco. Malformations of the vertebrae. Principles of paediatric neurosurgery; 1989: 1-18.

Robinson S, Cohen AR. Myelomeningocele and related neural tube defects. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 65.

Downloads

Published

2019-12-11

How to Cite

Dr. Shashank Mohole, Dr. Harish Jadhav, & Dr. Sunil Natha Mhaske. (2019). Anaesthetic Challenges & Management of Myelomeningocele Repair. VIMS Health Science Journal, 6(4), 95–98. https://doi.org/10.46858/dvvpf.j.

Issue

Section

Articles

Most read articles by the same author(s)

1 2 > >>