TY - JOUR
T1 - A Single Center's Experience With Spinal Anesthesia for Pediatric Patients Undergoing Surgical Procedures
AU - Heydinger, Grant
AU - Roth, Catherine
AU - Kidwell, Rachel
AU - Tobias, Joseph D.
AU - Veneziano, Giorgio
AU - Jayanthi, Venkata R.
AU - Whitaker, Emmett E.
AU - Thung, Arlyne K.
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/6
Y1 - 2024/6
N2 - Purpose: To perform a single institution review of spinal instead of general anesthesia for pediatric patients undergoing surgical procedures. Spinal success rate, intraoperative complications, and postoperative outcomes including unplanned hospital admission and emergency department visits within seven days are reported. Methods: Retrospective chart review of pediatric patients who underwent spinal anesthesia for surgical procedures from 2016 until 2022. Data collected included patient demographics, procedure and anesthetic characteristics, intraoperative complications, unplanned admissions, and emergency department returns. Results: The study cohort included 1221 patients. Ninety-two percent of the patients tolerated their surgical procedure without requiring conversion to general anesthesia, and 78% of patients that had spinals placed successfully did not receive any sedation following lumbar puncture. The most common intraoperative event was systolic blood pressure below 60 mm Hg (14%), but no cases required administration of vasoactive agents, and no serious intraoperative adverse events were observed. Post-Anesthesia Care Unit Phase I was bypassed in 72% of cases with a median postoperative length of stay of 84 min. Forty-six patients returned to the emergency department following hospital discharge, but no returns were due to anesthetic concerns. Conclusions: Spinal anesthesia is a viable and versatile option for a diversity of pediatric surgical procedures. We noted a low incidence of intraoperative and postoperative complications. There remain numerous potential advantages of spinal anesthesia over general anesthesia in young pediatric patients particularly in the ambulatory setting. Level of Evidence: IV. Type of Study: Retrospective cohort treatment study.
AB - Purpose: To perform a single institution review of spinal instead of general anesthesia for pediatric patients undergoing surgical procedures. Spinal success rate, intraoperative complications, and postoperative outcomes including unplanned hospital admission and emergency department visits within seven days are reported. Methods: Retrospective chart review of pediatric patients who underwent spinal anesthesia for surgical procedures from 2016 until 2022. Data collected included patient demographics, procedure and anesthetic characteristics, intraoperative complications, unplanned admissions, and emergency department returns. Results: The study cohort included 1221 patients. Ninety-two percent of the patients tolerated their surgical procedure without requiring conversion to general anesthesia, and 78% of patients that had spinals placed successfully did not receive any sedation following lumbar puncture. The most common intraoperative event was systolic blood pressure below 60 mm Hg (14%), but no cases required administration of vasoactive agents, and no serious intraoperative adverse events were observed. Post-Anesthesia Care Unit Phase I was bypassed in 72% of cases with a median postoperative length of stay of 84 min. Forty-six patients returned to the emergency department following hospital discharge, but no returns were due to anesthetic concerns. Conclusions: Spinal anesthesia is a viable and versatile option for a diversity of pediatric surgical procedures. We noted a low incidence of intraoperative and postoperative complications. There remain numerous potential advantages of spinal anesthesia over general anesthesia in young pediatric patients particularly in the ambulatory setting. Level of Evidence: IV. Type of Study: Retrospective cohort treatment study.
KW - Ambulatory anesthesia
KW - Outpatient surgery
KW - Pediatric anesthesia
KW - Regional anesthesia
KW - Spinal anesthesia
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U2 - 10.1016/j.jpedsurg.2024.02.001
DO - 10.1016/j.jpedsurg.2024.02.001
M3 - Article
C2 - 38418274
AN - SCOPUS:85186102949
SN - 0022-3468
VL - 59
SP - 1148
EP - 1153
JO - Journal of pediatric surgery
JF - Journal of pediatric surgery
IS - 6
ER -