Muhammad Iqbal Memon, Muhammad Ashraf, Anwarul Haq.
Our experience of anesthesia in the management of Esophageal atresia and Tracheoesophageal fistula.
Ann Pak Inst Med Sci Jan ;1(1):24-6.

Objective: To review anaesthesia management in cases of congenital esophageal atresia with tracheoesophageal fistula repair. Duration of Study: From Jan 2003 to Dec 2004. Setting: Department of Anaesthesia, the Children Hospital, Pakistan Institute of Medical Sciences, Islamabad. Design: A descriptive, observational study. Patients and Procedure: All neonates anaesthetized for oesophageal atresia with tracheoesophageal fistula were included in the study. Anaesthesia record was reviewed retrospectively. Detailed scrutiny of record was carried out to analyze the technique of anaesthesia administered and airway management, incidence of per-operative complications. Ninety three cases were anaesthetized for repair of esophageal atresia with tracheoesophageal fistula from January 2003 to December 2004. Anaesthetic management included inhalational induction, endotracheal intubation, followed by muscle relaxation. Per-operative problems managed accordingly. Standard reversal given and extubation performed when awake in recovery. Results: Age ranged from 24 hours to 17 days (mean 4 days) and weight from 1.4-3.5 Kg (mean 2.0 Kg). Male to female ratio was 1:2. Oxygen desaturation was observed in 08 patients. One patient had cardiac arrest, but revived successfully. Twelve patients were already on mechanical ventilation and so they were continued on ventillator for 2-5 days. Thirteen patients had gastrostomy due to long gap atresia. Conclusion: Our technique of endotracheal intubation under deep anaesthesia followed by muscular paralysis and controlled ventilation has better outcome and does not increase the rate of per-operative complications.

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