Anesthetic challenges in leaking meningomyelocele repair in a neonate

Abstract

Meningomyelocele is a neural tube defect, which comprises of a saccular protrusion containing a neural placode bathed in cerebral spinal fluid. Arachnoid covers the surface of the sac and dura or skin is missing. This is a congenital spinal anomaly, a type of spina bifida where there is a failure of fusion of spine. Early surgery is advisable because of increased risk of infection and further damage to nervous tissue. Anesthetic challenges for meningomyelocele surgical repair in a neonate include intubation with proper positioning to avoid rupture of sac, intraoperative prone position ventilation and its related complications maintenance of anesthesia, temperature control, and fluid management. We present a case report of anesthetic challenge of a 2-day-old neonate for detethering and repair of lumbosacral meningomyelocele.

Keywords

• Arnold–Chiari malformation
• hypothermia
• intratracheal
• intubation
• meningomyelocele
• neural tube defect
• prone position
• spinal dysraphism