Challenges of Anesthetic Management in Pediatric Patients with Hernia Inguinalis Lateralis Dextra Reponibilis: A Case Report

Puspita Wahyu Lestari, Muh Iswan Wahab, Gede Indrajaya
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Abstract

Introduction: Hernia inguinalis lateralis dextra reponibilis (HILD repr.) is a common condition in infants and children, but anesthetic management in these pediatric patients requires special attention. Children's unique physiological and pharmacological characteristics, potential comorbidities, and risk of postoperative pain demand a careful and integrated approach. Case presentation: This case report presents comprehensive anesthetic management of a 6-month-old male infant who underwent elective herniorrhaphy for HILD repr. The anesthesia procedure involved induction with sevoflurane and fentanyl, maintenance of anesthesia with sevoflurane, and multimodal pain management with paracetamol and bupivacaine. The surgery was successful without complications, and the patient recovered well. Conclusion: This case highlights the importance of implementing modern anesthetic practices in pediatric patients with HILD repr., including selection of appropriate anesthetic agents, close monitoring, and multimodal pain management. Specific challenges such as unique airway anatomy, variability in drug pharmacokinetics, and risk of perioperative complications are also highlighted. The successful anesthetic management of this case highlights the importance of an individualized approach and close monitoring to optimize clinical outcomes and minimize complications in pediatric patients with HILD repr.
小儿腹股沟侧右再疝患者麻醉管理的挑战:病例报告
导言:腹股沟外侧疝(HILD repr.)是婴幼儿的常见病,但这些儿童患者的麻醉管理需要特别注意。儿童独特的生理和药理特征、潜在的并发症以及术后疼痛的风险要求我们采取谨慎而综合的方法。病例介绍:本病例报告介绍了一名 6 个月大的男婴因 HILD 再发而接受选择性疝成形术的综合麻醉管理。麻醉过程包括使用七氟醚和芬太尼诱导,使用七氟醚维持麻醉,以及使用扑热息痛和布比卡因进行多模式止痛。手术很成功,没有出现并发症,患者恢复良好。结论本病例强调了对 HILD 复发的儿科患者实施现代麻醉方法的重要性,包括选择适当的麻醉剂、密切监测和多模式疼痛管理。本病例还强调了一些特殊的挑战,如独特的气道解剖结构、药物药代动力学的可变性以及围手术期并发症的风险。本病例成功的麻醉管理突出了个体化方法和严密监测的重要性,以优化 HILD 儿童患者的临床效果并最大限度地减少并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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