Spinal anaesthesia in the neonate

Frawley, Geoff; Ingelmo, Pablo

doi:10.1016/j.bpa.2010.02.018

Cited by 30 publications

(56 citation statements)

References 82 publications

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“…The dural sac ends at the L4 vertebra at birth but reaches S2 by the end of the first year of life (Figure 1) [13]. Shin et al confirmed that the end of the dural sac was at a median level of the upper S2 in children aged less than 36 months of age [14].…”

Section: Anatomical Structure Of and Differences In Vertebral Columnmentioning

confidence: 61%

“…Another anatomical difference in paediatric patients is the flexibility of a child's spine and intervertebral spaces, which are easily palpated [13]. In addition to these characteristics, ossification of the vertebral lamina is incomplete, and the spinal needle can readily enter the bone.…”

Section: Anatomical Structure Of and Differences In Vertebral Columnmentioning

confidence: 99%

“…In premature infants (approximately 90%), the spinal cord terminates between the L2-L3 vertebra [10]. In newborns, the spinal cord extends down to the level of the L3 lumbar vertebra, compared with the L1 lumbar vertebra in adults (Figure 1) [11][12][13].…”

Section: Anatomical Structure Of and Differences In Vertebral Columnmentioning

confidence: 99%

“…vertebral column at the L4-5 or L5-S1 interspace, well below the termination of the spinal cord [13]. Therefore, the L4-5 or L5-S1 intervertebral space should be used for needle placement in children.…”

Section: Anatomical Structure Of and Differences In Vertebral Columnmentioning

confidence: 99%

“…In infants, the intercristal line passes through the Figure 1. Anatomical structure and differences between paediatric and adult invertebral column (Remodified from Frawley and Ingelmo [13]). …”

Section: Anatomical Structure Of and Differences In Vertebral Columnmentioning

confidence: 99%

See 4 more Smart Citations

Spinal Anaesthetic Management in Paediatric Surgery

Caliskan¹

2017

Pediatric and Neonatal Surgery

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The first paediatric cases involving the use of spinal anaesthesia were published at the end of the nineteenth century. However, the technique did not receive much interest in paediatric anaesthesia until the 1980s. In the last three decades, paediatric spinal anaesthesia has received widespread approval as an alternative technique to general anaesthesia in school-/preschool-aged children, particularly in term and preterm neonates with high risk associated with general anaesthesia. The development of new and safer local anaesthetics mainly through better understanding of the pharmacokinetics and dynamics and dedicated paediatric tools are the keys to this success. Paediatric spinal anaesthesia is an easy and effective technique, and its high efficiency and safety are supported by the presence of numerous publications from the medical literature. However, it remains limited to situations in which general anaesthesia poses a major risk. Despite these advances, it is important to understand the correct technique and the anatomy of children at different ages. Also, the appropriate equipment, the pharmacokinetics and toxicities of local anaesthetics and the indications and complications of paediatric regional blocks should be well known. The goal of this chapter is to review and discuss some of these topics of paediatric spinal anaesthesia for paediatric surgery.

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Section: Anatomical Structure Of and Differences In Vertebral Columnmentioning

confidence: 61%

Section: Anatomical Structure Of and Differences In Vertebral Columnmentioning

confidence: 99%