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Spinal anesthesia instead of general anesthesia for infants undergoing tendon Achilles lengthening

Authors AlSuhebani M, Martin DP, Relland LM, Bhalla T, Beebe AC, Whitaker AT, Samora W, Tobias JD

Received 21 November 2017

Accepted for publication 20 February 2018

Published 3 May 2018 Volume 2018:11 Pages 25—29

DOI https://doi.org/10.2147/LRA.S157650

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 3

Editor who approved publication: Dr Stefan Wirz


Mohammad AlSuhebani,1 David P Martin,1,2 Lance M Relland,1,2 Tarun Bhalla,1,2 Allan C Beebe,3 Amanda T Whitaker,3 Walter Samora,3 Joseph D Tobias1,2

1Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 2Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; 3Department of Orthopedic Surgery, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, OH, USA

Abstract: Spinal anesthesia (SA) has been used relatively sparingly in the pediatric population, as it is typically reserved for patients in whom the perceived risk of general anesthesia is high due to comorbid conditions. Recently, concern has been expressed regarding the potential long-term neurocognitive effects of general anesthesia during the early stages of life. In view of this, our center has developed a program in which SA may be used as the sole agent for applicable surgical procedures. While this approach in children is commonly used for urologic or abdominal surgical procedures, there have been a limited number of reports of its use for orthopedic procedures in this population. We present the use of SA for 6 infants undergoing tendon Achilles lengthening, review the use of SA in orthopedic surgery, describe our protocols and dosing regimens, and discuss the potential adverse effects related to this technique.

Keywords: spinal anesthesia, orthopedic surgery, tendon Achilles lengthening

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