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Epidural analgesia in a newborn with Hirschsprung's disease, associated with congenital central hypoventilation syndrome

Published online by Cambridge University Press:  16 August 2006

M. J. A. Brouwers ,
J. J. Driessen  and
R. S. V. M. Severijnen
M. J. A. Brouwers
Affiliation:
Department of Anesthesiology, University Medical Centre St Radboud, Nijmegen, PO Box 9101, 6500 HB, The Netherlands
J. J. Driessen
Affiliation:
Department of Anesthesiology, University Medical Centre St Radboud, Nijmegen, PO Box 9101, 6500 HB, The Netherlands
R. S. V. M. Severijnen
Affiliation:
Department of Pediatric Surgery, University Medical Centre St Radboud, Nijmegen, PO Box 9101, 6500 HB, The Netherlands
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Abstract

A case is presented of a neonate with Hirschsprung's disease, associated with congenital central hypoventilation syndrome. After an ileostomy (at 2 days) and a stoma revision (at 10 days), postoperative pain management was established by continuous intravenous infusion of morphine, which caused severe postoperative respiratory depression. At 6 weeks a reexploration and stoma revision was performed using postoperative epidural analgesia with bupivacaine. This caused no respiratory depression. A colectomy under epidural analgesia at 8 months was also uneventful. Respiratory difficulties in children with congenital central hypoventilation syndrome associated with Hirschsprung's disease are discussed in relation to the technique of choice for postoperative pain management.

Keywords

hirschsprung diseaseanalgesiaepiduralanalgesics opioidmorphinesleep apnoea syndromessleep apnoeacentral
Type
Clinical Letter
Information
European Journal of Anaesthesiology , Volume 17 , Issue 12 , December 2000 , pp. 751 - 753
Copyright
2000 European Society of Anaesthesiology

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