The effectiveness and safety of spinal anaesthesia in the pyloromyotomy procedure

Abstract

This study proposes that spinal anaesthesia is an alternative option to general anaesthesia in infants undergoing pyloromyotomy, and should be considered in infants undergoing pyloromyotomy.

A Study of Spinal Anaesthesia in Paediatric patients of aged 2-8 years

“…In 1900, Bainbridge reported a case of strangulated hernia repair under spinal anaesthesia in an infant of three months. Thereafter, in 1909-1910 Tyrell Gray, a British surgeon published a series of 200 cases of lower abdominal surgeries in infants and children under spinal anaesthesia 1,2,3,4 . After some years it fell into disuse because of the introduction of various muscle relaxants and inhalational agents and was almost unused after World War II.…”

Ultrasound-guided paravertebral block for pyloromyotomy in 3 neonates with congenital hypertrophic pyloric stenosis

“…The classic clinical picture is characterized by projectile vomiting, malnutrition, dehydration and electrolyte and metabolic disturbances. 1 The treatment of this condition consists of the performance of pyloromyotomy under general anesthesia and orotracheal intubation, 2 which is a challenge for anesthesiologists given the risk of bronchopulmonary aspiration, 3,4 and frequent metabolic alterations in the context of a general anesthesia by hyperventilation 3,4 or administration of opioids and neuromuscular blockers may increase the risk of central apnea. An operation under general anesthesia combined with locoregional techniques could reduce the risk of apnea and postoperative complications.…”

“…An operation under general anesthesia combined with locoregional techniques could reduce the risk of apnea and postoperative complications. 3,5 …”

The Pierre Limoges Pediatric Anesthesia Lecture: Tricky problems in pediatric anesthesia

“…7 There are reports of caudal, as well as spinal anesthesia, being used for this procedure. [8][9][10] Spinal anesthesia has been reported as effective and safe in this patient population. Somri describes the successful use of spinal anesthesia in 23 of 25 infants scheduled for pyloromyotomy, using hyperbaric bupivacaine 0.5%, 0.8 mg·kg -1 .…”

“…Somri describes the successful use of spinal anesthesia in 23 of 25 infants scheduled for pyloromyotomy, using hyperbaric bupivacaine 0.5%, 0.8 mg·kg -1 . 10 The sensory levels achieved ranged between T3 and T5. Hemodynamic variables remained stable during the procedure when compared to the prespinal levels.…”