Spinal anesthesia instead of general anesthesia for infants undergoing tendon Achilles lengthening

Alsuhebani, Mohammad; Martin, David P.; Relland, Lance M.; Bhalla, Tarun; Beebe, Allan; Whitaker, Amanda T.; Samora, Walter; Tobias, Joseph D.

doi:10.2147/lra.s157650

Cited by 8 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Various methods of anesthesia have been used, including sedation, general anesthesia, and spinal anesthesia. [45][46][47][48] Caution for postoperative apnea regardless of anesthetic type should be taken for patients born full term but less than 30 days old or born preterm and less than 60 weeks postconceptual age. 49 Extended hospital stay or overnight stay should be planned in this subset of patients.…”

Section: Club Footmentioning

confidence: 99%

Pediatric Anesthesia Concerns and Management for Orthopedic Procedures

2020

Pediatric Clinics of North America

View full text Add to dashboard Cite

Section: Club Footmentioning

confidence: 99%

Pediatric Anesthesia Concerns and Management for Orthopedic Procedures

2020

Pediatric Clinics of North America

View full text Add to dashboard Cite

“…There is a large number of publications reflecting great success of pediatric spinal anesthesia particularly for inguinal herniorrhaphy. 2 In many situations general anesthesia in children becomes a tricky option. Respiratory tract infections produce bronchial hyperactivity resulting in constriction of smooth muscles in the respiratory tract, which may persist for 6 weeks even after clinical symptoms have disappeared.…”

Section: Introductionmentioning

confidence: 99%

Factors resulting in underutilization of pediatric spinal anesthesia in South Punjab (Pakistan)

Durrani

Sadaf

Naqvi

et al. 2020

APIC

View full text Add to dashboard Cite

Background & objectives: Spinal anesthesia in children a useful alternative to general anesthesia, is not usually practiced in most of the hospitals of South Punjab. We aimed to evaluate the utilization of spinal anesthesia in children in South Punjab (Pakistan) and to discover the elements preventing its use in children. Methodology: A questionnaire was delivered to all 47 FCPS qualified anesthesiologists working in South Punjab vide e-mail and whatsapp messages to them. Out of 47 anesthesiologists, 38 (80.85%) responded. Questionnaire consisted of 3 components. All participants were asked to fill the first component regarding demographic data, but only those who did not administer spinal in children, needed to fill second and third components. In the second component, structured questions with scale 1 to 5 (strongly disagree to strongly agree). In the third component, the participant had open choice to write three most important factors (most important, second most and third most) prohibiting the practice of spinal anesthesia in children. Results: All of the 47 senior anesthesiologists working in South Punjab were included in this survey. The response rate was 80.85%. Demographic data showed 33/38 (87%) males and 05/38 (13%) females, mean age 44.34 ± 11.06 yrs, mean of total experience in anesthesia 17.03 ± 9.12 yrs and mean experience after postgraduation 8.01 ± 6.85 yrs. The number of respondents administering spinal anesthesia in children was just 3 (7.88%) and 35 (92%) never used spinal in children. Lack of expertise/training/guidance (4.69 ± 0.83) is the most common cause prohibiting the use of pediatric spinal anesthesia followed by risk of high/total spinal (4.14 ± 1.31), lack of cooperation of child (3.83 ± 1.34), risk of spinal cord injury (3.71 ± 1.51), difficulty in assessment of block (3.34 ± 1.64). Less common factors avoiding pediatric spinal include objection by family, objection by surgeon and lack of proper recommendations. The number of participants considering lack of expertise/training/guidance most important factors for avoiding spinal anesthesia in children was 9 (25.71%), followed by uncooperative children 8 (22.86%), risk of spinal cord damage 5 (14.28%), risk of high/total spinal 3 (8.57%) and objection by family 3 (8.57%). Other factors quoted were objection by the surgeon, risk of postdural puncture headache, risk of neurological complications, being short duration, not recommended and not acceptable by society. Conclusion: Pediatric spinal anesthesia is practiced by only three consultants (7.88%) in South Punjab out of a total of 47. There is a need to enhance the expertise level of the anesthesiologists during postgraduate training and to remove the fears / phobias attached with this particular practice. Key words: Pediatric; Anesthesia, Spinal; Barriers; South Punjab Citation: Durrani HD, Sadaf S, Naqvi SAA, Siddique A, Bajwa MH. Factors resulting in underutilization of pediatric spinal anesthesia in South Punjab (Pakistan). Anaesth. pain intensive care 2020;24(6):--- Received: 20 August 2020, Reviewed: 17 October 2020, Revised: 25 October 2020, Accepted: 6 October 2020

show abstract

“…Although a small series of 6 cases employing SP has been published, there has not been a large series of cases reported. 13 We report our experience with 30 consecutive cases of PAT in infants performed with SP.…”

mentioning

confidence: 99%

Spinal Anesthesia is Superior to General Anesthesia for Percutaneous Achilles Tenotomy in Infants

Acquaviva

Caltoum²,

Bielski³

et al. 2021

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

Background: Concern about the effects of inhaled, halogenated anesthetics on neurodevelopment of infants has renewed interest in regional anesthesia as an alternative to general anesthesia (GA). Infants undergoing percutaneous Achilles tenotomy (PAT) are well suited for spinal anesthesia (SP). Methods: Thirty infants (mean age: 2.3 mo) undergoing PAT with SP were compared with 15 infants (mean age: 2.0 mo) undergoing PAT with GA. Data collected included perioperative times, heart rate and blood pressure, and the administration of opioids.Results: Ten of 15 GA (67%) patients received perioperative opioids as opposed to 1 of 30 SP patients (3.3%) (P < 0.0001). The time from the start of anesthesia to the start of surgery was shorter in the SP group (8.5 vs. 14 min, P < 0.0009). The time from the start of anesthesia to first oral intake was shorter in the SP group (12 vs. 31 min, P < 0.0033). The time of first phase recovery (phase 1 post anesthesia care unit) was shorter in the SP group (15.5 vs. 34 min, P < 0.0026). Surgery time was not significantly different between the groups (SP: 15.5 min, GA: 15 min, P = 0.81). Conclusion: Infants undergoing PAT with SP received less opioid, did not require an airway device, did not receive potent inhaled, halogenated hydrocarbon anesthetics, and exhibited faster and qualitatively better postoperative recovery. Level of Evidence: Level III-case control study.

show abstract

Spinal anesthesia instead of general anesthesia for infants undergoing tendon Achilles lengthening

Cited by 8 publications

References 25 publications

Pediatric Anesthesia Concerns and Management for Orthopedic Procedures

Pediatric Anesthesia Concerns and Management for Orthopedic Procedures

Factors resulting in underutilization of pediatric spinal anesthesia in South Punjab (Pakistan)

Spinal Anesthesia is Superior to General Anesthesia for Percutaneous Achilles Tenotomy in Infants

Contact Info

Product

Resources

About