What are the postoperative concerns in TEF patients?
The postoperative management of TEF patients depends upon the degree of pulmonary dysfunction and the presence of associated anomalies. In healthy, vigorous infants, extubation of the trachea at the completion of surgery is not only possible but also desirable, in order to decrease the stress at the surgical anastomosis.
Postoperative pain management may be accomplished by either neuraxial analgesia or intravenous opioids. For neuraxial analgesia, a thoracic epidural catheter is placed via the caudal approach. Position of the catheter should be confirmed radiographically prior to starting an infusion of a local anesthetic and opiate solution.
Postoperative survival in healthy infants approaches 100%, but may be affected by prematurity, severity of pulmonary dysfunction, and associated anomalies.