Anaesthesia Perioperative Management in Laparotomy Procedure in Neonates with Tetralogy of Fallot (ToF): A Case Study

Abstract

Tetralogy of Fallot (TOF) is a congenital heart condition characterized by right ventricular hypertrophy, pulmonary stenosis, aortic overriding, and ventricular septal defect. Its presence raises mortality and perioperative risk. Noncardiac abnormalities associated with this condition include neurological, musculoskeletal, and ophthalmological defects, all of which were present in the index case. The complexity of the heart lesion, coupled with individuals' potential to compensate, the urgency of the operation, and numerous concurrent conditions all present challenges for anesthesiologists when dealing with patients with cyanotic congenital heart disease (CHD) who require extracardiac surgery. The objectives of anaesthesia in patients with ToF are to minimize pulmonary vascular resistance (PVR), maintain or raise systemic vascular resistance (SVR), and prevent intraoperative hypercyanotic episodes. To investigate a case report in neonates with tetralogy of Fallot and discuss further anaesthesia perioperative management in laparotomy procedure in neonates with tetralogy of Fallot (ToF). A 20-days female neonate, weighing 1,9 kg, was referred to our hospital with the diagnosis of high-level bowel obstruction et causa suspect atresia duodenum dd duodenal stenosis, tetralogy of Fallot (ToF), and a Secundum Atrial Septal Defect (ASD) with ASA IV. The patient was planned to undergo general anaesthesia for explorative laparotomy surgery. There were hemodynamic changes during surgery, but they can be appropriately managed. Anaesthesia and surgery were successful, and the patient improved. Preoperative, Durante-operative, and postoperative management was shown. Tetralogy of Fallot (TOF) Children generally have congenital heart defects. Preoperative planning, managing anaesthesia during surgery, and typical postoperative problems in the critical care unit are all perioperative considerations. The procedure will be completed successfully with the help of careful planning and a solid understanding of physiological and pharmacological principles.