Repair of duodenal atresia under spinal anesthesia in a low-birth-weight preterm neonate: case report

Duodenal atresia is a well-recognized cause of neonatal bowel obstruction. General anesthesia with tracheal intubation is the traditional anesthetic technique for surgical correction of this condition. Metabolic abnormalities and fluid deficits coupled with residual anesthetics are known to increase the risk of postoperative apnea, prolonging the operating room time and delaying extubation. Spinal anesthesia (SA) is an accepted alternative to general anesthesia in formerly preterm infants. In the current literature, there are reports of successful use of SA for simple infraumbilical surgery and, occasionally, for upper abdominal surgery, but there is no information on the use of SA in neonates for duodenal atresia repair. We present a case of duodenal atresia in a preterm infant at a gestational age of 30 weeks with coexisting bronchopulmonary dysplasia successfully repaired under SA. Further studies that compare the adverse effects with the potential advantages of SA are warranted before future recommendations are made for neonates who are undergoing upper abdominal surgery.