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Cover page of the Journal of Health Sciences
CASE REPORT
Year : 2020  |  Volume : 13  |  Issue : 1  |  Page : 50-53

An infant with hydrocephalus and lumbar meningomyelocele for ventriculoperitoneal shunt insertion: Concerns of an anesthesiologist


Department of Anaesthesiology, Pondicherry Institute of Medical Sciences, Puducherry, India

Correspondence Address:
Dr. Ramyavel Thangavelu
Department of Anaesthesiology, Pondicherry Institute of Medical Sciences, Kalathumettupathai, Ganapathichettikulam, Village 20, Kalapet, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_172_19

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The anatomical and physiological differences in children make the administration of anesthesia difficult compared to the adults which is made more challenging when the child presents with a congenital anomaly. In this case, we report the anesthetic challenges presented by an 8-month-old baby born of full gestation with a lumbar swelling and hydrocephalus posted for ventriculoperitoneal shunt insertion. Magnetic resonance imaging scan revealed the presence of a large meningomyelocele with tethered sac and Arnold–Chiari malformation (Type 2). Anesthetic management included a thorough preoperative assessment of associated comorbidity, proper positioning, management of a difficult airway, prevention of any rise in intracranial pressure, and prevention of hypothermia. The perioperative period was uneventful, and the child recovered well.


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