Treatment of Immediately Postoperative Hypercyanotic Spell in an Infant With Continuous Fentanyl Infusion

Main Article Content

Pipat Saeyup

Abstract

Hypercyanotic spell or TET spell is an emergency life
threatening condition. Sedation is a necessary treatment
aiming to calm, attenuating sympathetic activity and
breaking pathophysiology of TET spells. This case
scenario points out that fentanyl infusion, a commonly
used opioid, can be administered for management of
immediately postoperative TET spell in infants with
Tetralogy of Fallot (TOF).
We present the case of an eight-month old infant with
unrepaired TOF who had TET spell immediately after
operation, and whose oxygen saturation dropped to
65%. The patient did not respond to knee-to-chest
positioning, vasoconstrictor and fluid administration. The
symptoms were improved by sedation, fentanyl was bolus
intravenously following continuous infusion, within a few
minutes. Subsequently, the patient underwent a successful
right modified Blalock-Taussig Shunt procedure on 20th
postoperative day. Conclusion: fentanyl infusion should
be considered as an alternative sedation and analgesia
of choice for postoperative TET spell patients.

Article Details

Section
Case reports

References

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