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.
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