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Paediatric spinal anaesthesia: Difference between revisions
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→APPLICATIONS OF SPINAL ANAESTHESIA
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== APPLICATIONS OF SPINAL ANAESTHESIA == | == APPLICATIONS OF SPINAL ANAESTHESIA == | ||
SA remains popular for ex-premature infants, specifically those undergoing inguinal herniorraphy. These patients often have a history of apnoea of prematurity, bronchopulmonary dysplasia and chronic lung disease. The incidence of postoperative apnoeas correlates with gestational age at birth, the post-conceptional age at surgery, weight, anaemia and a history of apnoeas. General anaesthesia increases the risk of apnoea and bradycardia, and ex-premature infants remain at risk until after 60 weeks post- conception.<ref>Welborn LG, Rice LJ, Hannalah RS, Broadman LM, Ruttimann VE, Fink R. Post-operative apnea in former infants: prospective comparison of spinal and general anesthesia. Anesthesiology 1990; 72: 838-42.</ref><sup>,</sup><ref>Tobias JD. Spinal anaesthesia in infants and children. Paediatric Anaesth 2000; 10: 5-16.</ref> | SA remains popular for ex-premature infants, specifically those undergoing inguinal herniorraphy. These patients often have a history of apnoea of prematurity, bronchopulmonary dysplasia and chronic lung disease. The incidence of postoperative apnoeas correlates with gestational age at birth, the post-conceptional age at surgery, weight, anaemia and a history of apnoeas. General anaesthesia increases the risk of apnoea and bradycardia, and ex-premature infants remain at risk until after 60 weeks post- conception.<ref>Welborn LG, Rice LJ, Hannalah RS, Broadman LM, Ruttimann VE, Fink R. Post-operative apnea in former infants: prospective comparison of spinal and general anesthesia. Anesthesiology 1990; 72: 838-42.</ref><sup>,</sup><ref name=":4">Tobias JD. Spinal anaesthesia in infants and children. Paediatric Anaesth 2000; 10: 5-16.</ref> | ||
Outside the neonatal period, SA has been used for general surgery (rectal biopsy, incision of rectal abscess), urological surgery (orchidopexy, circumcision), lower limb orthopaedic surgery,<ref name=":5">Dalens B, Veyckemans F. Traité d’Anesthésie Loco-Régionale, de la naissance à l’âge adulte. Montpellier: Sauramps Médical 2008, 463-512.</ref><sup>,</sup> and may be of particular use in developing countries as an alternative to general anaesthesia. | Outside the neonatal period, SA has been used for general surgery (rectal biopsy, incision of rectal abscess), urological surgery (orchidopexy, circumcision), lower limb orthopaedic surgery,<ref name=":5">Dalens B, Veyckemans F. Traité d’Anesthésie Loco-Régionale, de la naissance à l’âge adulte. Montpellier: Sauramps Médical 2008, 463-512.</ref><sup>,</sup> and may be of particular use in developing countries as an alternative to general anaesthesia. | ||