Pyeloplasty

Pyeloplasty

  • Ureteropelvic junction (UPJ) obstruction often produces hydronephrosis. A pyeloplasty is done in infants or toddlers with UPJ obstruction to eliminate the obstruction and improve renal function. At UCSF, the procedure is accomplished via an open approach. Other centers opt for laparoscopic or robotic techniques.
  • Premedication: versed 0.5-1 mg/kg in response to patient's need, clinical status, and parents' input. Infants younger than 9-12 months may not require premedication.
  • Inhalational induction with nitrous oxide and sevoflurane
  • Peripheral IV after induction
  • +/- muscle relaxant/propofol to facilitate intubation of the trachea, according to patient's status and preference of the anesthesiologist.
  • Consider caudal morphine 50 mcg/kg
  • Lateral positioning requires attention to avoid arm and neck hyperextension
  • Trachea extubated either awake or under deep anesthesia, according to patient's status and preference of the anesthesiologist.
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This information is meant to serve as an educational resource. Clinicians should use their own professional judgment in the care of any individual patient as the guidance contained in this document may not be appropriate for all patients or all situations.