Anaesthetic management of an Extremely Low Birth Weight (ELBW) neonate with multiple co-morbidities

Anaesthetic management of an extremely low birth weight (ELBW) neonate is always a challenge. Challenges are substantial beginning from pre-operative preparation till the neonate has been shifted to the neonatal intensive care unit. We report a case of an ELBW neonate who was operated twice for necrotising enterocolitis on day thirteen and day nineteen of life, weighing 815 grams and 746 grams respectively. Perioperative management and repair of the perforation due to necrotising enterocolitis was done on two occasions owing to the recurrence in a neonate with multiple co-morbidities. A planned approach and appropriate preparation led to a smooth peri-operative course both the times. This report discusses the multiple anaesthetic challenges and emphasises the role of a closed loop functioning among paediatric anaesthesiologists, neonatologists and the paediatric surgeons.