Combined spinal and epidural anaesthesia for major abdominal surgery in infants

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
R K WilliamsJ C Abajian

Abstract

Subarachnoid anaesthesia is becoming increasingly popular in neonates and infants. However, single dose spinal anaesthesia is of limited value for major abdominal surgery in infants due to its short duration of action and inability to provide analgesia in the post operative period. A new technique of combined spinal and epidural anaesthesia for major abdominal surgery in the infant is described. Data were gathered prospectively from 19 infants presenting for upper and lower abdominal surgery. Anaesthesia was induced with a subarachnoid injection of tetracaine. After the subarachnoid block was established, an epidural catheter was placed for further intraoperative and postoperative management. Data collected included age and weight of the patients, type and duration of the surgical procedure. Doses of local anaesthetics as well as the need for intraoperative and postoperative supplements were recorded. An illustrative case report is provided. Infants studied represented a wide range of weights (1520-7840 g). Spinal anaesthesia was successful in all 19 patients. A variety of extensive surgical procedures including small bowel resections and various genitourinary procedures were successfully performed. In 17 patients a functioning...Continue Reading

References

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Citations

Apr 21, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·J M Peutrell
Jan 16, 1998·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·J D Tobias
May 15, 2012·Pediatric Surgery International·Mostafa SomriIbrahim Matter
Aug 10, 2000·Anesthesiology Clinics of North America·N RawalA Van Zundert
Oct 8, 2003·Best Practice & Research. Clinical Anaesthesiology·Narinder Rawal, Björn Holmström
Oct 8, 2003·Best Practice & Research. Clinical Anaesthesiology·George Lederhaas
Jan 13, 2000·Paediatric Anaesthesia·J D Tobias
May 3, 2000·Paediatric Anaesthesia·A S McCormick, V L Thomas
Oct 5, 2006·Current Opinion in Anaesthesiology·Christian Seefelder
Mar 15, 2006·Current Opinion in Anaesthesiology·Franco PuncuhHannu Kokki
Dec 22, 2005·Anesthesia and Analgesia·Robert K WilliamsJ Christian Abajian
Feb 28, 2014·Journal of Anaesthesiology, Clinical Pharmacology·Anju Gupta, Usha Saha
Oct 5, 2014·Journal of Pediatric Surgery·Saleem IslamNorman Carvallho
Aug 27, 2013·Clinics in Perinatology·Adrian Bosenberg, Randall P Flick
Jul 1, 2002·Medical Journal, Armed Forces India·F B BhotN K Biswas
Jul 5, 2011·Paediatric Anaesthesia·Adrian T BösenbergAndrew R Wolf
Sep 9, 2011·Paediatric Anaesthesia·Hannu Kokki
Jun 3, 2004·Best Practice & Research. Clinical Anaesthesiology·Keiko Kinouchi
Sep 28, 2007·Paediatric Anaesthesia·Mostafa SomriLuis A Gaitini
Sep 25, 2002·Paediatric Drugs·Joel B Gunter
Jun 11, 2014·Anesthesia and Analgesia·Robert K WilliamsH W Bud Meyers
May 29, 2001·Anesthesia and Analgesia·G CucchiaroY Nivoche
Sep 12, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Khaled Mohamed FaresAmira Mahmoud Mohamed Osman

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