ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Surgery
Volume 13 - 2025 | doi: 10.3389/fped.2025.1540435
This article is part of the Research TopicAdvances and Challenges in Neonatal Surgery: Congenital and Acquired ConditionsView all 13 articles
Delayed extubation and hypertrophic pyloric stenosis: What are the predictive factors?
Provisionally accepted
Sabrine Ben Youssef1
Syrine Laribi1*
Sawsen Chakroun2Maha Ben Mansour2Myriam Ben Fredj1
Afef Toumi1Radhouen Ben Salah1
Amine Ksia1
MEKKI Mongi1Mohsen Belghith1Samia Belhassen1Lassaad Sahnoun1- 1Department of Pediatric Surgery, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- 2Department of Anaesthesia and Intensive Care, Fattouma Bourguiba University Hospital, Monastir, Tunisia
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Introduction: Prolonged time to extubation after general anesthesia has been defined as a delay of more than 15 minutes from the end of surgery to tracheal extubation. This incident is frequently seen in infants operated on for hypertrophic pyloric stenosis (HPS), which can lead to inefficient use of operating rooms and delayed care for other patients.Aim: To evaluate the frequency of "delayed extubations" in infants who have received an extramucosal pyloromyotomy under general anesthesia and to identify the predictive factors of this incident.Methods: We report a retrospective and comparative study of patients operated for HPS at the pediatric surgery department of Monastir, between January 2020 and December 2023. Results:Thirty-four cases were collected. Delayed extubation occurred in 19 cases with very prolonged extubation (>60min) in 3 cases. The mean age at diagnosis was 38.07 days for group 1 and 34.42 days for group 2. The average of operating time was 56 minutes for both groups. On the χ2 test, the difference between the groups was significant for metabolic alkalosis. However, the results were not significant for the other criteria (prematurity, hypotrophy, dehydration, hyponatremia, hypochloremia, hypokalemia, functional renal failure, pre-operative resuscitation time). Conclusions: These data suggest that metabolic alkalosis is predictive of delayed extubation in infants operated on for HPS under general anesthesia. The use of spinal anesthesia may be an alternative to general anesthesia but it remains a controversial issue, as there are few comparative data. Key words: Hypertrophic pyloric stenosis, infant, general anesthesia, delayed extubation, metabolic alkalosis
Keywords: hypertrophic pyloric stenosis, Infant, general anesthesia, Delayed extubation, Metabolic alkalosis
Received: 05 Dec 2024; Accepted: 14 Jun 2025.
Copyright: © 2025 Ben Youssef, Laribi, Chakroun, Ben Mansour, Ben Fredj, Toumi, Ben Salah, Ksia, Mongi, Belghith, Belhassen and Sahnoun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Syrine Laribi, Department of Pediatric Surgery, Fattouma Bourguiba University Hospital, Monastir, Tunisia
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