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Paediatric spinal anaesthesia: Difference between revisions
→TECHNIQUE OF SA IN CHILDREN
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The operator should use sterile gloves, gown and mask and the patient’s skin should be cleaned with an alcoholic solution such as 0.5% or 2% chlorhexidine (+/- iodine). The skin should be allowed to dry and a sterile sheet should be placed over the child with a hole to reveal the field. The dose of local anaesthetic solution is calculated according to the weight of the child and is shown in Table 2;<ref name=":5" /><sup></sup> the drugs should be drawn into a 1-2ml syringe as appropriate and placed on the sterile work surface in preparation for use. | The operator should use sterile gloves, gown and mask and the patient’s skin should be cleaned with an alcoholic solution such as 0.5% or 2% chlorhexidine (+/- iodine). The skin should be allowed to dry and a sterile sheet should be placed over the child with a hole to reveal the field. The dose of local anaesthetic solution is calculated according to the weight of the child and is shown in Table 2;<ref name=":5" /><sup></sup> the drugs should be drawn into a 1-2ml syringe as appropriate and placed on the sterile work surface in preparation for use. | ||
Both the sitting or lateral decubitus position have been described for lumbar puncture.4,5 We have great experience of the lateral position for awake neonates or infants but careful attention must be directed at maintaining patency of the airway which may be compromised with overzealous positioning (Figure 1). | Both the sitting or lateral decubitus position have been described for lumbar puncture.<ref name=":4" /><sup>,</sup><ref name=":5" /><sup>,</sup> We have great experience of the lateral position for awake neonates or infants but careful attention must be directed at maintaining patency of the airway which may be compromised with overzealous positioning (Figure 1). | ||
The lateral position may be easier than the sitting position for older patients for whom intravenous sedation with a benzodiazepine such as midazolam may be indicated. | The lateral position may be easier than the sitting position for older patients for whom intravenous sedation with a benzodiazepine such as midazolam may be indicated. | ||