Opioid free anesthesia in a pre-term neonate: A case report

Opioids play a major role in the perioperative management of pain in adults and children. Though there is significant morbidity and mortality associated with overdosage of opioids, they remain the most common means of providing analgesia in the perioperative period. We report the case of a preterm neonate born with low birth weight who underwent high sigmoid loop colostomy for high anorectal malformation using opioid-free general anesthesia with supplementation with caudal block. Successful uncomplicated extubation of preterm baby was achieved with good spontaneous efforts. Opioid free general anesthesia can prevent respiratory depression and the need for postoperative mechanical ventilation even when given to preterm neonates

Cystic adenomatoid malformation of the lung: A diagnostic dilemma

Congenital cystic adenomatoid malformation (CCAM) of the lung is an uncommon anomaly that arises from excessive disorganised proliferation of tubular bronchial structures excluding the alveoli. These are believed to represent focal pulmonary dysplasia because skeletal muscle may be identified from within the cyst wall. This report describes a case of an infant operated for presumed diagnosis of congenital diaphragmatic hernia. Diaphragm was found to be normal and further investigations revealed cystic mass in the lower lobe of the left lung. Thoracotomy was done to resect the lesion that revealed a type II CCAM on histopathological examination. The case stresses the need for better clinical examination and advanced radiological investigations in doubtful cases