Pyloric Stenosis

Pyloric Stenosis

  • Preoperatively, ensure adequate hydration and correction of electrolyte abnormalities to achieve a bicarbonate concentration < 30 mEq/L; Cl > 100 mEq/L
  • Most patients are 2-3 months old and therefore require no premedication
  • Consider delivering atropine 20mcg/kg prior to induction of anesthesia
  • Place oral/nasal gastric (NG/OG) tube to empty stomach before induction of anesthesia. The volume of gastric contents is often significant (e.g., >100 cc).
  • In addition, consider suctioning the stomach with the patient in the lateral position. Remove NG/OG before induction.
  • "Rapid sequence induction" with propofol and muscle relaxant (succinylcholine vs rocuronium) and cricoid pressure (3.0 cuffed endotracheal tube)
  • Orogastric tube after induction
  • Rectal tylenol;
  • No/minimal narcotic, request that surgeon infuse local into wound
  • Awake extubation
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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.