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Indian Journal of Anesthesia and Analgesia 12(2):p 137-139, April -June 2025. | DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.10
Case Report
Anaesthetic Management of Pediatric Patient Posted for Spina Bifida Surgery
Mukesh Simhadri, Kiran Nelamangala, Ravi Madhusudhana, Akhil Kumar
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Anesthesia and Analgesia 12(2):p 137-139, April -June 2025. | DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.10
How Cite This Article:
Simhadri M, Nelamangala K, Madhusudhana R, Kumar A. Anaesthetic management of pediatric patient posted for spina bifida surgery. Ind J Anesth Analg. 2025;12(2):137-139.Timeline
Received : February 10, 2025
Accepted : April 10, 2025
Published : June 23, 2025
Abstract
Introduction: Spina bifida is a major birth defect that is a result of failure of the neural tube to close in the developing fetus. It is associated with varying degrees of neurologic impairment. The anatomic level of the lesion generally correlates with the neurologic motor and sensory deficit and ranges from complete paralysis to minimal or no motor deficit. Case Report: A 3 year old male child who was diagnosed with spina bifida was posted for spina bifiida surgery. The patient had swelling in the lower back region associated with right lower limb weakness since birth. Patient developed continuous dribbling of urine. An MRI Lumbar spine was done which showed defect in the S1, S2, and S3 vertebrea with posterior herniation of spinal cord, neural placode and nerve roots which is suggestive of closed spinal dysarphism, spina bifida with lipo-myelocoele. After through pre anaesthetic check-up, patient was posted for surgery. Patient was intubated with 4.5mm portex uncuffed endo tracheal tube and patient was kept in prone position. Standard monitoring was ensured intra operatively. With a total blood loss of 150ml which is within the maximum allowable blood loss limit, and total of 600ml of IV fluids were given to prevent volume overload. Neurosurgeon wanted an awake test which was a challenge for us as patient was on uncuffed tube so, electromyography was used and TIVA with propofol was maintained to check after the corrective surgery. After the surgery patient was shifted to pediatric intensive care unit with ET tube in situ. Patient was extubated the following day. Conclusion: As the pediatric patient was posted for spina bifida surgery which is a major surgery which took around 6-7 hours. Blood loss, fluid status, pain post- operative hypoxia were of major concern. Amount of IV fluids to be given intra-operatively, maximum allowable blood loss were calculated prior to surgery. The anaesthetic management was successfully done here without any adverse events.
References
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- 2. Sarwark John F. spina bifida. Pediatr Clin North Am 1996; 43(5): 1151-8.
- 3. Silva T., Queiroz J.R., Turcio K.H.L., Tobelem D.D.C., Araújo T.R., Coutinho K.S.L. et al. Effect of photobiomodulation combined with physical therapy on functional performance in children with myelomeningocele: A protocol randomized clinical blind study. PLoS One. 2021; 16(10): e0253963.
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- 5. Ho P., Quigley M.A., Tatwavedi D., Britto C., Kurinczuk J.J. Neonatal and infant mortality associated with spina bifida: A systematic review and meta-analysis. PLoS ONE 2021; 16(5): e0250098.
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Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
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Conflicts of Interest
The authors report no conflicts of interest in this work.
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Cite this article
Simhadri M, Nelamangala K, Madhusudhana R, Kumar A. Anaesthetic management of pediatric patient posted for spina bifida surgery. Ind J Anesth Analg. 2025;12(2):137-139.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| February 10, 2025 | April 10, 2025 | June 23, 2025 |
DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.10
Keywords
Anaesthetic managementElectromyographyPediatric anaesthesiaSpina bifidaSearch for Similar Articles
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Timeline
| Received | February 10, 2025 |
| Accepted | April 10, 2025 |
| Published | June 23, 2025 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
