The Safety and Efficacy of Spinal Anesthesia for Surgery in Infants: The Vermont Infant Spinal Registry

Abstract

Studies with modest numbers of patients have suggested that spinal anesthesia in infants is associated with a very infrequent incidence of complications, such as hypoxemia, bradycardia, and postoperative apnea. Although spinal anesthesia would seem to be a logical alternative to general anesthesia for many surgical procedures, it remains an underutilized technique. Since 1978, clinical data concerning all infants undergoing spinal anesthesia at the University of Vermont have been prospectively recorded. In all, 1554 patients have been studied. Anesthesia was performed by anesthesia trainees and attending anesthesiologists. The success rate for LP was 97.4%. An adequate level of spinal anesthesia was achieved in 95.4% of cases. The average time required to induce spinal anesthesia was 10 min. Oxygen hemoglobin desaturation to <90% was observed in 10 patients. Bradycardia (heart rate <100 bpm) occurred in 24 patients (1.6%). This study confirms the infrequent incidence of complications associated with spinal anesthesia in infants. Spinal anesthesia can be performed safely, efficiently, and with the expectation of a high degree of success. Spinal anesthesia should be strongly considered as an alternative to general anesthesia for lower abdominal and lower extremity surgery in infants.

Risk factors for spinal anesthesia in preterm infants undergoing inguinal hernia repair

“…A utilização da raquianestesia durante cirurgias em recém-nascidos pré-termo tem recebido ampla aceitação, porque esse tipo de anestesia é relativamente simples de administrar e apresenta baixo risco de complicações intraoperatórias [1][2][3][4][5][6][7][8] .…”

Combined Spinal and Caudal Epidural Anesthesia for Prolonged Surgical Procedures in Pediatric-Aged Patients: A Report of Two Cases

“…As it is a single-shot technique, it can only be used for procedures that last approximately 1 hour [11,12]. Adjunctive agents such as epinephrine or clonidine can be added to the local anesthetic agent that may extend that duration 20-30%, but the upper limit of duration remains 70 -75 minutes [13].…”

Effect of Spinal Anaesthesia in Children of 4-10 Years

“…William et al 22 conducted a study in 1554 infants undergoing major abdominal and thoracic surgeries. Success rate was 97.4% which was almost similar to our success rate (96.1%).…”