Addressing challenges in anesthesia management for patent ductus arteriosus ligation in a preterm baby: a case report

Patent ductus arteriosus (PDA) is a cardiac anomaly where the ductus arteriosus, a blood vessel connecting the pulmonary artery and the aorta, fails to close completely after birth. Anesthesia management during bedside PDA ligation in the Neonatal Intensive Care Unit (NICU) presents unique challenges and higher risks compared to the operating room environment. Manual cardiovascular and respiratory monitoring may be inefficient and challenging for the anesthesiologists. This case report aims to discuss the anesthetic management of a one month and four days old male infant, who presented with respiratory distress since birth, was diagnosed with moderate PDA, respiratory distress syndrome, and in need of surfactant therapy. This report focuses on the utilization of total intravenous anesthesia (TIVA) without inhalation anesthesia for PDA ligation via left posterolateral thoracotomy performed at the bedside in the NICU.