Postoperative pain management of liver transplantation in cy
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Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anaesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anaesthetic techniques improve outcomes by reducing anaesthetic drugs and administration of opioids, and hastening extubation, awakening and restarting respiratory of physiotherapy. There is a growing evidence that thoracic epidural anaesthesia is feasible in pediatric patients. Concerns about coagulopathy and immunosuppression have limited its use in liver transplantation. Ultrasonography is becoming an adjunct tool in neuraxial blocks, allowing faster and easier recognition of the epidural space, and reducing vertebral touch and number of attempts. In pediatric patients, it is still debated whether anaesthesia has detrimental effects on cognitive development. Efforts to make regional techniques easier and safer by ultrasonography are ongoing.This article reports the first case of continuous thoracic epidural analgesia after pediatric liver transplantation in a 10-year-old boy affected with CF with macronodular cirrhosis...

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