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Chapter 68 - Pyloric Stenosis

from Section 7 - Pediatric Anesthesia

Published online by Cambridge University Press:  03 August 2023

By
Luis A. Vargas-Patron
Edited by
Jessica A. Lovich-Sapola
Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

A 3-week-old male infant, born 2 weeks premature and now weighing 4 kg, is scheduled for a pyloromyotomy. He has a history of nonbilious emesis for the past 5 days. He is limp and lethargic. His current vital signs are heart rate (HR) 168, respiratory rate (RR) 54, and blood pressure (BP) 72/35 mm Hg. His recent laboratory findings include an unremarkable complete blood count, Na+ 130, K+ 2.5, and Cl− 85. What are your concerns? Is this an emergency surgery? Should his electrolytes be corrected prior to surgery? What should they be corrected to? How would you induce anesthesia for this patient?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
 , pp. 288 - 290
Publisher: Cambridge University Press
Print publication year: 2023

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References

Cook-Sather, SD, Tulloch, V, Cnaan, A, et al. A comparison of awake versus paralyzed tracheal intubation for infants with pyloric stenosis. Anesth Analg 1998;86:945–51.Google ScholarPubMed
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Gagey, AC, de Queiroz Siqueira, M, Desgranges, FP, et al. Ultrasound assessment of the gastric contents for the guidance of the anaesthetic strategy in infants with hypertrophic pyloric stenosis: a prospective cohort study. BJA 2016;116(5):649–54.CrossRefGoogle ScholarPubMed
Jobson, M, Hall, NJ. Contemporary management of pyloric stenosis. Semin Pediatr Surg 2016;25:219–24.CrossRefGoogle ScholarPubMed
Kamata, M, Cartabuke, RS, Tobias, J. Perioperative care of infants with pyloric stenosis. Pediatr Anesth 2016;25:1193–206.Google Scholar
Litman, RS. Pediatric Anesthesia: The Requisites in Anesthesiology, 1st ed. Philadelphia: Mosby, 2004, p. 233.Google Scholar
Schwartz, D, Connelly, NR, Manikantan, P, Nichols, JH. Hyperkalemia and pyloric stenosis. Anesth Analg 2003;97:355–7.CrossRefGoogle ScholarPubMed
Stoelting, RK, Dierdorf, SF. Anesthesia and Co-existing Disease, 4th ed. Philadelphia: Churchill Livingstone, 2002, p. 700.Google Scholar

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