Use of Spinal Anaesthesia in Neonates and Infants in Antananarivo, Madagascar: A Retrospective Descriptive Study

Randriamizao, Harifetra Mamy Richard; Rakotondrainibe, Aurélia; Razafindrabekoto, Lova Dany Ella; Ravoaviarivelo, Prisca Funken; Rajaonera, Andriambelo Tovohery; Andriamanarivo, Mamy Lalatiana

doi:10.21203/rs.3.rs-33908/v5

Cited by 1 publication

(2 citation statements)

References 6 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For all the above reasons, spinal block has become our first choice technique in infants undergoing lower body surgery lasting <90 min. 26,[34][35][36][37] The major limitation of this study was the use of retrospective data and therefore the possibility of missing key information, mostly related to accuracy in the collection of recovery times of motor block in the postanesthesia care unit, and also to complications and adverse effects occurring after the early postoperative period, which might not have been detected or recorded. Moreover, despite interoperator variability was practically nonexistent, there has been some degree of intraoperator variability during the 11-year study period, mainly regarding the experience gathered, drug selection for procedural sedation, and changes in local anesthetics dosage regimens as the program evolved.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric spinal anesthesia at a tertiary care hospital: Eleven years after

Rebollar

Palacios

Guerrero

et al. 2022

Pediatric Anesthesia

View full text Add to dashboard Cite

Anesthesia-related critical incidents in pediatric patients occurred three times more frequently than in adults and, moreover, three times higher in infants (<1 year of age) than in children (>1 year of age). The overall incidence of critical events requiring intervention is 35%, most of them related to hypotension and hypoxemia episodes, occurring during the maintenance of anesthesia. The major risk factors in children undergoing anesthesia are age (<1 year), prematurity (<37 weeks of gestation), and comorbidity (American Society of Anesthesiologists [ASA] physical status ≥3). [1][2][3] Pediatric spinal anesthesia was initially described by August Bier in 1898, and its use was rather common before the advent of halogenated agents that made anesthesia safer. However, spinal block did not become popular again until 1980s, when Abajian first described the high-risk infant (subsequently defined as the ex-premature infant whose postmenstrual age [PMA] at surgery is <60 weeks) as a target patient for this technique, and over the last few years, due to the growing concern about the potential general anesthetic-induced neurotoxicity in young children. [4][5][6][7][8] While its current use is not so widespread, this technique has various advantages compared to general anesthesia, by reducing the risk of cardiorespiratory events (hypoxemia, bradycardia, and hypotension) associated with general anesthesia, especially in neonates and infants. The main limitation is the duration of the anesthetic block, which reduces the number of surgical procedures to be undertaken under this technique to those lasting less than 90 min. [9][10][11] The objective of this study was to review the pediatric spinal anesthesia program at our tertiary care center-Puerta del Mar

show abstract

Section: Discussionmentioning

confidence: 99%

“…Moreover, the implementation of the pediatric spinal anesthesia program in our hospital had an excellent acceptance and adoption rate among the anesthesiologists and residents of our department. For all the above reasons, spinal block has become our first choice technique in infants undergoing lower body surgery lasting <90 min 26,34–37 …”

Section: Discussionmentioning

confidence: 99%