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BJA Advance Access published online on June 17, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei171
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org
Accepted March 24, 2005

Case Report

Anaesthetic management of a neonate with congenital cyst adenoid malformation

V. Guruswamy 1*, S. Roberts 1, P. Arnold 1, and F. Potter 1

1 Jackson Rees Department of Anaesthesia, The Royal Liverpool Children's Hospital NHS Trust, Alder Hey, Eaton Road, Liverpool L12 2AP, UK

* To whom correspondence should be addressed.
V. Guruswamy, E-mail: umavelu18{at}aol.com


  Abstract

We report the anaesthetic management of a male neonate with congenital cyst adenoid malformation (CCAM) of the lung who underwent thoracotomy for resection of CCAM 24 h after birth and again at 24 days. The initial operation involved a 10-day admission to a paediatric intensive care unit (PICU) requiring ventilation, and was complicated by a pneumothorax. This report concentrates on the anaesthetic management for the second thoracotomy. The combination of intra-operative remifentanil infusion and the use of ultrasound to confirm correct placement of epidural catheter allowed on-table tracheal extubation and a shorter stay in PICU. The use of one-lung ventilation (OLV) allowed for better surgical access and enabled complete resection of the lesion.

Keywords: anaesthesia; anaesthetic techniques, epidural; complications, congenital cystic adenoid malformation; measurement techniques, ultrasound; ventilation, one lung.
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