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A 28 week gestational neonate who is now 14 days old and weights 2.1 kg is scheduled for thoracotomy and left lower lobectomy. Appropriate methods of pain control include all of the following EXCEPT:

a) Caudal epidural placed at T5-7 with ropivacaine infusion

b) Morphine 0.1 mg/kg bolus IV

c) Local skin infiltration w 2 mL of 0.25% bupivacaine by surgeon

d) Ketorolac 0.5 mg/kg IV bolus

e) Acetaminophen 40 mg/kg/day divided q 8 hour

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Answer

Answer d. This neonate is now 30 weeks post-gestational age and is too young to receive intravenous ketorolac due to immature renal function. Local preferences will dictate the management of these patients, but all of the remaining responses are age- and weight-appropriate therapies for this patient.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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