Does gastroschisis reduction require general anesthesia?

Abdominal wall defects: Prenatal diagnosis, newborn management, and long-term outcomes

“…61 Quick protection of extruded bowel is mandatory at birth by means of sterile wet sponges and aluminum foil, cling-film, or plastic bag, together with the right flank decubitus in order to limit a possible vascular damage. The definitive covering, either primary or staged, should be undertaken within the next 4-7 h. 73,74 Besides coverage or reduction of the intestine, a central line needs to be inserted at the time of first repair or within a few days. Even if loops are apparently little damaged, in fact, still many days are usually required for peristalsis to be actively functioning, and in the meantime, the infant needs to be totally or partially supported by parenteral nutrition.…”

Factors Affecting the Outcome in Patients with Gastroschisis: How Important Is Immediate Repair?

“…A study by Davies et al suggested that reducing the bowel without general anesthesia on the ward (rather than in an operating room) decreases the need for MV, TPN, and reduces overall LOS [6] . While Cauchi et al found no contraindications to repair on the ward, they stated that the only outcome which was significantly improved by reduction without general anesthesia was the cost of hospitalization [7] . The data Cauchi presented also showed signifi cant diff erences in age at repair (the ward group was, on average, younger), the duration of the reduction (shorter in the ward group) and overall co-morbidity (lower in the ward group).…”

Anaesthetic management of gastrochisis – a review of our practice over the past 5 years

“…This is seen following full closure whereas placement of the bowel contents in a spring loaded silo or silastic pouch could potentially decrease this complication (4). This has been quoted as a reason for promoting the use of a spring loaded silo and delayed closure (1–4).…”

“…This is seen following full closure whereas placement of the bowel contents in a spring loaded silo or silastic pouch could potentially decrease this complication (4). This has been Table 2 Comparison of demographic data and the requirement for postoperative ventilation between neonates who received a regional technique and those who received opioids quoted as a reason for promoting the use of a spring loaded silo and delayed closure (1)(2)(3)(4). We compared full closure as one group and spring loaded silo ⁄ silastic pouch as another group.…”