Disposition of levobupivacaine during intraoperative continuous caudal epidural analgesia in a preterm neonate.

Background: Continuous caudal epidural analgesia used intraoperatively in children is an effective and safe technique. However, in preterm neonates, developmental factors may significantly affect levobupivacaine disposition, leading to variable pharmacokinetics, pharmacodynamics, and potential large-variable systemic toxicity of local anesthetics.

Objective: To our knowledge, this is the first case report describing the disposition of levobupivacaine used for intraoperative caudal epidural analgesia in a preterm neonate treated for the postoperative pain profile.

Anastomotic stricture prediction in patients with esophageal atresia with distal fistula.

Purpose: To investigate potential early risk factors for anastomotic stricture formation and assess the predictive role of post-operative esophagrams.

Methods: A retrospective study of patients with esophageal atresia with distal fistula (EA/TEF) operated between 2011 and 2020. Fourteen predictive factors were tested for stricture development.

Plasma concentrations of levobupivacaine in neonates during caudal epidural analgesia maintained over 48 hours.

Background: Differences in neonatal pharmacokinetics are known to cause systemic accumulation of levobupivacaine with adverse effects during epidural analgesia. Therefore, it is not recommended to surpass 48 hours of administration in neonates. Free and total levobupivacaine levels are considered as predictors of toxicity.

Gastric tumors in children: single-center study with emphasis on treatment of repeated recurrence.

Purpose: Analysis of surgical management and survival of pediatric patients with gastric tumors treated at our institution.

Methods: A retrospective study of patients with primary gastric tumors treated between 1993 and 2018 was conducted.

Results: Eight patients, five girls and three boys, were diagnosed with gastric tumors at an average age of 10.

Indications and outcomes of duodenum-preserving resection of the pancreatic head in children.

Aim Of Study: Duodenum-preserving resection of the pancreatic head (DPRPH) with Roux-en-Y pancreatojejunostomy is a procedure used to remove focal pathological lesions of the pancreatic head. Although predominantly used in adult patients, it is both safe and effective in children. The aim of this study was to review our experience with this procedure, with focus on its indications, complications and long-term outcomes.