Thoracic epidural analgesia and immediate extubation for less than 10 kg infants undergoing living donor liver transplantation: A report of two successful cases

Pediatr Transplant. 2022 Jun;26(4):e14242. doi: 10.1111/petr.14242. Epub 2022 Feb 5.

Abstract

Background: Perioperative pain management in small infants weighing <10 kg undergoing liver transplantation is challenging. The use of TEA in this setting has not been reported, as well as its potential role to facilitate IE, ie, in the OR.

Methods: We describe here the use of TEA in two small infants who had IE after a LDLT procedure.

Results: TEA was successfully performed and IE was achieved in both cases. Postoperative analgesia assessment in the OR was satisfactory according to the FLACC pain scale, with scores of 2 and 3 for each patient, respectively. There were no major complications in the postoperative period, and the two children were discharged home uneventfully.

Conclusions: The use of TEA and its influence on IE rate and other perioperative outcomes should be more explored in small infants undergoing LDLT.

Keywords: immediate extubation; pediatric liver transplantation; thoracic epidural.

Publication types

  • Case Reports

MeSH terms

  • Airway Extubation
  • Analgesia, Epidural* / methods
  • Child
  • Humans
  • Infant
  • Liver Transplantation* / methods
  • Living Donors
  • Pain Measurement