Successful management of neonatal tracheoesophageal fistula
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Introduction:
Surgical repair of trachea-esophageal fistula (TEF) is one of the major neonatal emergencies that poses many challenges to the treating neonatologist, intensivist, paediatric anaesthesiologist and the surgeon. Mostly these babies are premature having physiological immaturity of various organ systems and in association they may be having lung pathologies or other major congenital defects like VATER/VACTERL anomalies. Smooth induction /maintenance, adequate intra/post operative analgesia and uneventful postoperative recovery are the major objectives to be achieved with the anaesthetic plan. The use of regional anaesthesia (RA) has found to be very safe and effective when combined with general anaesthesia (GA).

Case Report:
We report a case of a one-day old baby for surgical repair of TEF (type IIIB) that was managed successfully with GA along with caudal epidural analgesia. The baby was induced and intubated under O2 +sevoflurane anaesthesia and maintained with muscle relaxant atracurium. Epidural catheter was passed upto T4 through caudal route to facilitate intra and post operative analgesia with ropivacaine. There was excellent hemodynamic stability, satisfactory perioperative pain relief and uneventful recovery...

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