Spinal anaesthesia in paediatrics

Lederhaas, George

doi:10.1016/s1521-6896(03)00017-x

Cited by 21 publications

(14 citation statements)

References 61 publications

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“…Finally, a senior specialist in pediatric anesthesia is available (24/7) on home call base. Furthermore, complications due to spinal anesthesia such as hematoma formation [27] or meningitis [28,29] have been described. Our data show that these complications are infrequent and might be avoidable by thorough technique and respecting exclusion criteria like coagulation disorders.…”

Section: Discussionmentioning

confidence: 99%

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

et al. 2014

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“…The use of spinal anesthesia in pediatric patients has been recently reviewed by several authors (10)(11)(12)(13)(14), and here, I will discuss some of the topics that may be interesting for the pediatric anesthetists.…”

Section: Introductionmentioning

confidence: 99%

Spinal blocks

Kokki

2011

Pediatric Anesthesia

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Every anesthetist should have the expertise to perform lumbar puncture that is the prerequisite to induce spinal anesthesia. Spinal anesthesia is easy and effective technique: small amount of local anesthetic injected in the lumbar cerebrospinal fluid provides highly effective anesthesia, analgesia, and sympathetic and motor block in the lower part of the body. The main limitation of spinal anesthesia is a variable and relatively short duration of the block with a single-injection of local anesthetic. With appropriate use of adjuvant or combining spinal anesthesia with epidural anesthesia, the analgesic action can be controlled in case of early recovery of initial block or in patients with prolonged procedures. Contraindications are rare. Bleeding disorders and any major dysfunction in coagulation system are rare in children, but spinal anesthesia should not be used in children with local infection or increased intracranial pressure. Children with spinal anesthesia may develop the same adverse effects as has been reported in adults, but in contrast to adults, cardiovascular deterioration is uncommon in children even with high blocks. Most children having surgery with spinal anesthesia need sedation, and in these cases, close monitoring of sufficient respiratory function and protective airway reflexes is necessary. Postdural puncture headache and transient neurological symptoms have been reported also in pediatric patients, and thus, guardians should be provided instructions for follow-up and contact information if symptoms appear or persist after discharge. Epidural blood patch is effective treatment for prolonged, severe headache, and nonopioid analgesic is often sufficient for transient neurological symptoms.

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“…With the increasing use of spinal anesthesia in pediatric anesthesia, there have been several detailed reviews highlighting the important aspects of this technique [20,37,38]. In the neonate or infant, the sitting position is generally preferred for spinal anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Spinal Anesthesia for Urologic Surgery in an Infant With Palliated Single Ventricle Physiology

et al. 2016

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Although commonly practiced in the adult population, spinal anesthesia has seen sporadic use in the pediatric population, being employed historically as a means of avoiding apnea following general anesthesia with halothane. With the emergence of evidence that specific anesthetic agents may affect future neurocognitive outcomes, there has been an increased focus on alternatives to general anesthesia, including spinal anesthesia. However, spinal anesthesia may also have applications in patients with co-morbid conditions that increase the risk of general anesthesia. We present the use of spinal anesthesia during urologic surgery in a 19-month-old boy with hypoplastic left heart syndrome who had undergone surgical palliation. The use of spinal anesthesia in patients with congenital heart disease is reviewed, potential hemodynamic consequences are presented, and the use of spinal anesthesia as an alternative to general anesthesia is discussed.

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Spinal anaesthesia in paediatrics

Cited by 21 publications

References 61 publications

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

Spinal blocks

Spinal Anesthesia for Urologic Surgery in an Infant With Palliated Single Ventricle Physiology

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