Meningomyelocele repair in a premature newborn with hydrocephalus: Anaesthetic confronts and management

Deficit of neural tube closure in the initial phases of intrauterine development leads to a gamut of abnormalities ranging from spina-bifida occulta,a relatively benign condition,to encephalocele and meningomyelocele,an anomaly in vertebral bodies,spinal cord and sometimes involving brainstem (in cervical meningomyelocele). meningomyelocele is the most common nonlethal malformation in the spectrum of neural tube deficits. the intrinsic challenges associated with the latter disorder warrants tailor-made approaches for providing anaesthesia to the requisite therapeutic surgical interventions. pediatric patients pose a set of natural barriers because of their ever budding and maturing neuro-physiological status,apart from the central neural disease process. hence,in order to provide optimal neuro-anaesthetic care,the anaesthesiologist must have the knowledge of the outcomes of various pharmacol ogi c i nt ervent i ons on cerebral aerodynamics apart from his professional experience in pediatric neuroanaesthesia. the current case report accounts for a challenging anaesthetic management in a premature newborn having hydrocephalus and lumbosacral meningomyelocele,presented for surgical repair within four hours of delivery. © journal of krishna institute of medical sciences university.