Gastroschisis, Pyloric stenosis and Congenital Hernia. Speaker: Dr. Monica Moderator: Prof. Sharmila Ahuja Dr. Nandita Joshi. University College of Medical Sciences & GTB Hospital, Delhi. www.anaesthesia.co.in. email: firstname.lastname@example.org. Introduction.
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Gastroschisis, Pyloric stenosis and Congenital Hernia
Speaker: Dr. Monica
Moderator: Prof. Sharmila Ahuja
Dr. Nandita Joshi
University College of Medical Sciences & GTB Hospital, Delhi
Early pregnancy- bowel loops seen floating in amniotic fluid
Later- bowel obstruction, peritonitis, bowel perforation, fetal growth restriction
i.v line preferably in upper limb
Inj Atropine 0.02 mg/kg i.v
PCM rectal suppository
iv Fentanyl (if on ventilatory support).
M:F - 4-5:1
Air filled fundus
Barium filled antrum
Narrowed pyloric channel
Surgery should only take place when dehydration corrected, normal S. Na and K, Cl⁻ > 90mmol/L, HCO₃ <28mmol/L and BE <+2.
ECG, NIBP, SpO₂
Acetaminophen 30-40mg/kg rectal suppository
LA infiltration of surgical incision
PONV- usually self limiting. Early feeding is recommended post op.
These are quite effective in providing postoperative pain relief and in decreasing intra-operative anaesthetic requirements.