Spinal anesthesia in children: A review
Even after a vast safety record, the role of spinal anesthesia (SA) as a primary anesthetic technique in children remains contentious and is mainly limited to specialized pediatric centers. It is usually practiced on moribund former preterm infants (<60 weeks post-conception) to reduce the incide...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2014-01-01
|
| Series: | Journal of Anaesthesiology Clinical Pharmacology |
| Subjects: | |
| Online Access: | http://www.joacp.org/article.asp?issn=0970-9185;year=2014;volume=30;issue=1;spage=10;epage=18;aulast=Gupta |
| _version_ | 1811314097583554560 |
|---|---|
| author | Anju Gupta Usha Usha |
| author_facet | Anju Gupta Usha Usha |
| author_sort | Anju Gupta |
| collection | DOAJ |
| description | Even after a vast safety record, the role of spinal anesthesia (SA) as a primary anesthetic technique in children remains contentious and is mainly limited to specialized pediatric centers. It is usually practiced on moribund former preterm infants (<60 weeks post-conception) to reduce the incidence of post-operative apnea when compared to general anesthesia (GA). However, there is ample literature to suggest its safety and efficacy for suitable procedures in older children as well. SA in children has many advantages as in adults with an added advantage of minimal cardio-respiratory disturbance. Recently, several reports from animal studies have raised serious concerns regarding the harmful effects of GA on young developing brain. This may further increase the utility of SA in children as it provides all components of balanced anesthesia technique. Also, SA can be an economical option for countries with finite resources. Limited duration of surgical anesthesia in children is one of the major deterrents for its widespread use in them. To overcome this, several additives like epinephrine, clonidine, fentanyl, morphine, neostigmine etc. have been used and found to be effective even in neonates. But, the developing spinal cord may also be vulnerable to drug-related toxicity, though this has not been systematically evaluated in children. So, adjuvants and drugs with widest therapeutic index should be preferred in children. Despite its widespread use, incidence of side-effects is low and permanent neurological sequalae have not been reported with SA. Literature yields encouraging results regarding its safety and efficacy. Technical skills and constant vigilance of experienced anesthesia providers is indispensable to achieve good results with this technique. |
| first_indexed | 2024-04-13T11:05:55Z |
| format | Article |
| id | doaj.art-be2e530dcb3a4ab1bea83117ef123fa9 |
| institution | Directory Open Access Journal |
| issn | 0970-9185 |
| language | English |
| last_indexed | 2024-04-13T11:05:55Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj.art-be2e530dcb3a4ab1bea83117ef123fa92022-12-22T02:49:16ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852014-01-01301101810.4103/0970-9185.125687Spinal anesthesia in children: A reviewAnju GuptaUsha UshaEven after a vast safety record, the role of spinal anesthesia (SA) as a primary anesthetic technique in children remains contentious and is mainly limited to specialized pediatric centers. It is usually practiced on moribund former preterm infants (<60 weeks post-conception) to reduce the incidence of post-operative apnea when compared to general anesthesia (GA). However, there is ample literature to suggest its safety and efficacy for suitable procedures in older children as well. SA in children has many advantages as in adults with an added advantage of minimal cardio-respiratory disturbance. Recently, several reports from animal studies have raised serious concerns regarding the harmful effects of GA on young developing brain. This may further increase the utility of SA in children as it provides all components of balanced anesthesia technique. Also, SA can be an economical option for countries with finite resources. Limited duration of surgical anesthesia in children is one of the major deterrents for its widespread use in them. To overcome this, several additives like epinephrine, clonidine, fentanyl, morphine, neostigmine etc. have been used and found to be effective even in neonates. But, the developing spinal cord may also be vulnerable to drug-related toxicity, though this has not been systematically evaluated in children. So, adjuvants and drugs with widest therapeutic index should be preferred in children. Despite its widespread use, incidence of side-effects is low and permanent neurological sequalae have not been reported with SA. Literature yields encouraging results regarding its safety and efficacy. Technical skills and constant vigilance of experienced anesthesia providers is indispensable to achieve good results with this technique.http://www.joacp.org/article.asp?issn=0970-9185;year=2014;volume=30;issue=1;spage=10;epage=18;aulast=GuptaAdditiveschildrencomplicationspediatricregional anesthesiaspinalspinal anesthesia |
| spellingShingle | Anju Gupta Usha Usha Spinal anesthesia in children: A review Journal of Anaesthesiology Clinical Pharmacology Additives children complications pediatric regional anesthesia spinal spinal anesthesia |
| title | Spinal anesthesia in children: A review |
| title_full | Spinal anesthesia in children: A review |
| title_fullStr | Spinal anesthesia in children: A review |
| title_full_unstemmed | Spinal anesthesia in children: A review |
| title_short | Spinal anesthesia in children: A review |
| title_sort | spinal anesthesia in children a review |
| topic | Additives children complications pediatric regional anesthesia spinal spinal anesthesia |
| url | http://www.joacp.org/article.asp?issn=0970-9185;year=2014;volume=30;issue=1;spage=10;epage=18;aulast=Gupta |
| work_keys_str_mv | AT anjugupta spinalanesthesiainchildrenareview AT ushausha spinalanesthesiainchildrenareview |