Abstract

We present perioperative problems in neonates with sacrococcygeal teratomas (SCT)undergoing surgical excision.We analyzed 11 neonates with SCT operated in the Polish Mother ’s Memorial Hospital in¸ Łódź, between 1999 and 2003. There were 4 small-sized tumors (less than 15%of the newborn body weight)where general anaesthesia with halothane or sevoflurane was used,and no complications noticed.In seven neonates with large SCT (about 33 –48%of body weight)surgical procedures were performed under high dose fentanyl anaesthesia and ventilation with FiO 2 0.75 –1.0.The patients ’course was complicated by severe,and mulidirectional problems including: hypovolaemia with hypotension, anemia, metabolic and respiratory acidosis, hypothermia, hypocalcaemia and hyperkalaemia. During procedures the maintenance of adequate ventilation and transfusion of sufficient amount of blood and plasma during extremely intensive and dynamic blood loss are of a great importance. In the authors ’opinion, the anaesthesia in case of a large SCT in newborns is one of the most challenging tasks of paediatric anaesthesiology.

Keywords: sacrococcygeal teratoma, neonate, general anaesthesia