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Case Report Anaesthetic Management of Mirschsprung Disease Complicated by Meconium Aspiration Syndrome and Pneumomediastinum in Newborn
We report one female newborn baby suffered from moderate asphyxia meconium aspiration syndrome, and Hirschsprung disease. The patient admitted in Neonatal intensive Care Unit (NICU) and ventilated with Pressure Controlled Mandatory Ventilation(PCMV) mode ventilator. Patient suffered from penumodiastinum and therefore mediastinotomy was performed. Sepsis and Necrotizing Enterocolitas (NEC) made the case more complicated. On further examination, abdominal was distended and perforated and therefore we decided to perform exploration laparatomy and sigmoidoctomy. Anaesthesia management with general anaesthesia had been performed. Premedication was not given. We used oxygen and Sevofluran for induction; Oxygen, Sevolfuran, Atracerium, Fentary, and Morphin for maintenance; and Morphin for post operative analgesic. On follow up examination, was found disrupton and therefore relaparatomy was performed. Types and doses of anesthesia drugs were chosen according to newborn immature organ noticely. Providing adeguate oxygenation, preventing hypotermi, and balancing electrolytes and acid base states still be the most considerations in management of this patient. Anesthetic management and intensive care of this patient gained a satistying 0utcome. The prognosis was good.
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