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Spinal anesthesia for surgery longer than 60 min in infants: experience from the first 2years of a spinal anesthesia program

Spinal anesthesia for surgery longer than 60 min in infants: experience from the first 2years of... Purpose Spinal anesthesia (SA) is being increasingly used in infants to avoid the potential negative neurocognitive effects of general anesthesia (GA). However, SA has been reported to provide a relatively short duration of surgical anesthesia. Methods We retrospectively reviewed SA cases for surgical procedures lasting more than 60 min in children up to 3 years old. All patients received bupivacaine 0.5% (1 mg/kg up to 7 mg) with clonidine 1 µg/kg ± epinephrine. The primary outcome was success of SA without subsequent conversion to GA. Results Thirty-five patients met inclusion criteria (all males, age 7 ± 5 months, weight 8 ± 2 kg). Procedures included male genital, groin and multiple site surgeries. Average surgical duration was 71 ± 12 min (range 60–111 min). SA was successful in 31 of 35 patients (89%; 95% confidence interval 78, 99%). The cause of failure was rarely due to the duration of surgery (1 of 4 patients). Six patients with successful SA required sedation with dexmedetomidine ± fentanyl. Differences in procedure duration and patient characteristics were not statistically significant between successful and failed SA. Conclusions SA is a highly successful technique and may offer an alternative to GA in children undergoing appropriate surgery expected to last as long as 60–100 min. Keywords http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Anesthesia Springer Journals

Spinal anesthesia for surgery longer than 60 min in infants: experience from the first 2years of a spinal anesthesia program

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References (26)

Publisher
Springer Journals
Copyright
Copyright © 2018 by Japanese Society of Anesthesiologists
Subject
Medicine & Public Health; Anesthesiology; Pain Medicine; Intensive / Critical Care Medicine; Emergency Medicine
ISSN
0913-8668
eISSN
1438-8359
DOI
10.1007/s00540-018-2517-5
Publisher site
See Article on Publisher Site

Abstract

Purpose Spinal anesthesia (SA) is being increasingly used in infants to avoid the potential negative neurocognitive effects of general anesthesia (GA). However, SA has been reported to provide a relatively short duration of surgical anesthesia. Methods We retrospectively reviewed SA cases for surgical procedures lasting more than 60 min in children up to 3 years old. All patients received bupivacaine 0.5% (1 mg/kg up to 7 mg) with clonidine 1 µg/kg ± epinephrine. The primary outcome was success of SA without subsequent conversion to GA. Results Thirty-five patients met inclusion criteria (all males, age 7 ± 5 months, weight 8 ± 2 kg). Procedures included male genital, groin and multiple site surgeries. Average surgical duration was 71 ± 12 min (range 60–111 min). SA was successful in 31 of 35 patients (89%; 95% confidence interval 78, 99%). The cause of failure was rarely due to the duration of surgery (1 of 4 patients). Six patients with successful SA required sedation with dexmedetomidine ± fentanyl. Differences in procedure duration and patient characteristics were not statistically significant between successful and failed SA. Conclusions SA is a highly successful technique and may offer an alternative to GA in children undergoing appropriate surgery expected to last as long as 60–100 min. Keywords

Journal

Journal of Anesthesia – Springer Journals

Published: May 28, 2018

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