Benefits of spinal anesthesia for urologic surgery in the youngest of patients

Implementation of a spinal anesthesia and sedation protocol that reliably prolongs infant spinal anesthesia: Case series of 102 infants who received spinal anesthesia for urologic surgery

“…10,11,20 The same group performed a retrospective single-center review of patients <90 days old who underwent urologic procedures under SA. 21 The SA success rate reported in this study was 80%, related to inability to obtain CSF (75%) or agitation during the surgical procedure (25%). Our study adds important data to the evolving practice that supports the use of SA in the infant population.…”

“…In particular, the use of sedation with dexmedetomidine ± fentanyl in addition to topical lidocaine provides comfort to the infants during block placement and avoids respiratory depression. Additionally, we saw less intraoperative agitation than the patients in these cohorts 20,21 …”

“…This study highlights the potential for the use of dexmedetomidine for sedation, although its effect is confounded by concurrent midazolam administration 10,11,20 . The same group performed a retrospective single‐center review of patients <90 days old who underwent urologic procedures under SA 21 . The SA success rate reported in this study was 80%, related to inability to obtain CSF (75%) or agitation during the surgical procedure (25%).…”

“…The number of spinal patients that we encountered in a 2-year time frame is moderate and comparable to other institutions. 20,21 Our patients represented a wide range within the expected age range and a wide distribution of weights. Our number of failed SA and failed duration incidents were minimal.…”

“…Additionally, we saw less intraoperative agitation than the patients in these cohorts. 20,21 The choice of sedation agent(s) is varied among practices performing SA in children. We selectively utilized dexmedetomidine as a primary sedation agent due to its minimal impact on respiratory depression and encouraging neurotoxicity profile.…”