Anaesthetic Challenges & Management of Myelomeningocele Repair

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.