Anaesthetic considerations in a prematurely born infant with congenital hypothyroidism presenting for cataract surgery

Abstract

Anaesthetic management of the premature infant is a challenge. This is owing to the immaturity of his or her organ systems and the possible presence of sequelae of premature birth, such as bronchopulmonary dysplasia, apnoea, patent ductus arteriosus and intraventricular haemorrhage. The premature infant is at risk of developing postoperative apnoea, hypothermia and hypoglycaemia until his or her postgestational age is more than 60 weeks. Conditions such as congenital bilateral cataract and congenital hypothyroidism may be associated with other birth defects and syndromes. Recommendations for early cataract surgery may necessitate anaesthetising premature infants with postconceptional ages less than 60 weeks, or those who have had recently diagnosed medical conditions,  such as hypothyroidism. We describe the anaesthetic considerations in a, so far, unreported scenario of a premature infant with bilateral congenital cataract and congenital hypothyroidism who presented for cataract surgery.