Iqbal M, Anwaarul Haq, Naheed Fatima.
Congenital diaphragmatic hernia - Anesthesia outcome in Children Hospital, PIMS.
Ann Pak Inst Med Sci Jan ;1(4):234-7.

Objective: To review anaesthesia outcome, in patients admitted for repair of congenita diaphragmatic hernia. Duration of Study: Nov 2000- July 2005. Setting: Department of Anaesthesia, Children Hospital, Pakistan Institute of Medica Sciences, Islamabad. Design: A descriptive observational study. Patients and Procedure: All children anaesthetized for repair of Congenital Diaphragmatic Hernia (CDH) were included in the study. Anaesthesia record was reviewed retrospectively. Detailed scrutiny of record was carried out to analyze the preoperative status of patient, perioperative problems and post-anaesthesia outcome. Twenty-eight cases were anaesthetized for repair of congenital diaphragmatic hernia from Nov 2000 to July 2005. Anaesthetic management included inhalational induction in neonates and intravenous induction in other age groups, endotracheal intubation after muscle relaxant followed by controlled ventilation. Perioperative problems were managed accordingly. Standard reversal was given to stable patients; while patients on mechanical support of breathing in preoperative period were continued with mechanical ventilation during postoperative period. Results: There were twenty-eight subjects among seventy thousand cases (0.164%] operated in pediatric surgery during study period. Age ranged from 2 days to 7 years and mean weight was 4.7 Kg (2.6-15.0 kg). Male to female ratio was 1:1.3. Eleven patients (39.2%) were received from intensive care unit, 6 were on preoperative vent support and continued the same post operatively. Five patients were kept in PICU for observation. 17 cases (60.7%; received from wards remained stable postoperatively and sent to ward care after extubation and recovery. Conclusion: Twenty-Eight patients were anesthetized for repair of a congenital diaphragmatic hernia with conventional method and had no intraoperative complication.

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