Spinal anesthesia is a blessing for children

Abstract

SIR-We congratulate Rukewe et al.(1) for their heading 'Spinal anesthesia in children: no longer an anathema' in the November issue of Pediatric Anesthesia.Spinal anesthesia has been used in children for over a hundred years. During our 4 years of experience with more than 800 children we experienced five cases of high spinal block (with 0.5 mgAEkg )1 hyperbaric bupivacaine) without major haemodynamic changes in preschool children which resolved quickly and was managed by mask ventilation under mild sedation. To the best of our knowledge no prospective randomised study shows that spinal anesthesia is not safe or not feasible for children from preterm neonates to adolescents. We are using spinal anesthesia not only as an alternative to general anesthesia but also as the first choice for suitable surgery in children with or without co-morbidity (2). We started to believe that spinal anesthesia has the potential in becoming the gold standard for children undergoing lower abdominal and lower extremity surgery and low dose spinal opioids to be an effective method for postoperative pain relief for children (2,3). Moreover, Rochette et al. (4) describes spinal anesthesia as a gold standard for neonatal surgery. Although we know that much more scientific evidence is required to set up gold standards for pediatric anesthesia procedures, until evidence to the contrary comes forward, we would like to believe that rather than being an anathema spinal anesthesia is a blessing for children.

Spinal anaesthesia for orthopaedic surgery in children with cerebral palsy: analysis of 36 patients

“… 11 , 12 In the last 20 years, its popularity for paediatric patients has increased, and numerous investigations have been performed in both healthy and high-risk children. 13 - 16 SA-related case reports are increasing in children with various neuromuscular disease, 14 , 17 but to knowledge, there is no prospective or retrospective study investigating the appropriateness of SA in children with CP.…”

Spinal anesthesia in children – let’s make it safe!

“…S ir —We read with great interest the correspondence by Sahin (1) titled ‘Spinal anesthesia a blessing in children’ and the study by Rukewe et al. (2) titled ‘Spinal anesthesia in children: no longer an anathema!’.…”