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Facilitation With Postoperative Muscle Paralysis

Steven M. Denmark, MD; Keith E. Georgeson, MD

Arch Surg. 1983;118(1):66-68.

Abstract
• Although most surgeons prefer primary closure of gastroschisis, staged closure is most commonly needed because of marked visceroabdominal disproportion. We have modified the usual primary fascial closure by introducing postoperative muscle paralysis through the use of a nondepolarizing neuromuscular blocking agent. The result was a higher percentage of patients amenable to primary closure. Twenty-nine patients with gastroschisis were treated by us during a 5-year period. Primary fascial closure was possible in 20 cases (69%). In 17 of the 20 patients, postoperative paralysis was induced for two to three days to avoid the complications associated with increased intraabdominal pressure. Postoperative complications were few.

(Arch Surg 1983;118:66-68)

Author Affiliations
From the Department of Surgery, Loma Linda (Calif) University Medical Center.

Footnotes
Accepted for publication Aug 16, 1982.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Newport Beach, Calif, Jan 22, 1982.

Reprint requests to Department of Surgery, Room 2573, Loma Linda University Medical Center, Loma Linda, CA 92350 (Dr Georgeson).

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