Management of hypertrophic pylorus stenosis with ultrasound guided single shot epidural anaesthesia – a retrospective analysis of 20 cases

Abstract

Background: Anaesthesia management for hypertrophic pylorus stenosis is usually performed

Ultrasound-guided paravertebral block for pyloromyotomy in 3 neonates with congenital hypertrophic pyloric stenosis

“…3 On the other hand, compared to other locoregional techniques described, from our experience, paravertebral block reduces the risk of respiratory failure associated with epidural block, is associated with fewer complications and, unlike the caudal block, ensures a sufficient analgesic level for this surgical technique. 1,5,7 …”

“…Willschke et al 1 describe an ultrasound-guided thoracic epidural technique under sedation as an alternative to general anesthesia for pyloromyotomy.…”

“…Pyloromyotomy requires a right supraumbilical incision, with analgesic level being required for this T4 surgery. 1 We present a novel anesthetic technique in patients with HPS undergoing pyloromyotomy, based on the performance of an ultrasound-guided thoracic paravertebral block (PVB) and administration of a single dose of local anesthetic under general anesthesia and tracheal intubation.…”

“…The classic clinical picture is characterized by projectile vomiting, malnutrition, dehydration and electrolyte and metabolic disturbances. 1 The treatment of this condition consists of the performance of pyloromyotomy under general anesthesia and orotracheal intubation, 2 which is a challenge for anesthesiologists given the risk of bronchopulmonary aspiration, 3,4 and frequent metabolic alterations in the context of a general anesthesia by hyperventilation 3,4 or administration of opioids and neuromuscular blockers may increase the risk of central apnea. An operation under general anesthesia combined with locoregional techniques could reduce the risk of apnea and postoperative complications.…”

“…Hypertrophic pyloric stenosis (HPS) is a gastrointestinal disorder inherent to childhood, with an incidence of 0.9 to 5.1/1.000 cases, 1 an average age of presentation of 5 weeks and an average weight of 4 kg −1 . The classic clinical picture is characterized by projectile vomiting, malnutrition, dehydration and electrolyte and metabolic disturbances.…”