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

Autor:	Tarun Bhalla, Dmitry Tumin, Joseph D. Tobias, Emmett E. Whitaker, Venkata R. Jayanthi, Mehdi Trifa
Rok vydání:	2018
Předmět:	Male medicine.medical_specialty Time Factors Sedation Anesthesia General Anesthesia Spinal Clonidine 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology 030225 pediatrics Anesthesiology Humans Medicine Sex organ Retrospective Studies Bupivacaine Groin business.industry Body Weight Infant Spinal anesthesia Confidence interval Surgery Fentanyl Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia medicine.symptom business Dexmedetomidine medicine.drug
Zdroj:	Journal of Anesthesia. 32:637-640
ISSN:	1438-8359 0913-8668
DOI:	10.1007/s00540-018-2517-5
Popis:	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. 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. 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. 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.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3ea4bd162d533c8df8bb4d886a13aeec https://doi.org/10.1007/s00540-018-2517-5 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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