Neonatal anaesthesia: Difference between revisions

Anorectal malformations (ARM) occur in approximately 1:5000 live births. They represent a wide spectrum of disease, from a simple membrane involving the distal rectum and anus to more complex anomalies involving the genital and urinary tract. Spinal anomalies are frequently found in these patients. These include spinal dysraphism, low lying cord (LLC) and tethered cord.<ref>Teo AT, Gan BK, Tung JS, Low Y, Seow WT. Low-lying spinal cord and tethered cord syndrome in children with anorectal malformations. Singapore Med J 2012; 53 570-6.</ref>  Plain spinal Xrays and spinal ultrasound are used to screen for these abnormalities although they may be normal in occult dysraphism. Caudal anaesthesia may be beneficial and can be used in ARM if there is certainty that anomalies of the spine and spinal cord have been excluded.<ref>Bozza P, Morini F, Conforti A, Sgrò S. Stress and ano-colorectal surgery in newborn/infant: role of anesthesia. Pediatr Surg Int 2012; 28 821-4.</ref> ARM may be associated with other anomalies including Vertebral, Anorectal, Cardiac, Tracheoesophageal, Renal and Limb abnormalities, collectively known as the VACTERL association.