Anesthesia and perioperative care of newborns with obstetrical brachial plexus injuries

Objectives: The perioperative period is a particularly dangerous time for babies with serious obstetrical brachial plexus injuries undergoing microsurgical reconstruction. The aim of this study was to evaluate the perioperative and early postoperative problems in these patients. Methods: Anesthetic management and pre and postoperative medical records were retrospectively reviewed for infants who underwent microsurgical nerve reconstruction (n=46) at the Hacettepe University, Ankara, Turkey from 1995 to 2003. Results: Anesthetic considerations include the positioning, long duration of operation, fluid administration, intra and postoperative fever, tachycardia and respiratory complications. Conclusion: Respiratory management and fluid administration are the most important factors in anesthesia for brachial injuries. Care must also be taken for the long duration of the surgery, temperature, and loss of airway.