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Subarachnoid microcatheter anesthesia in small children

K A Payne1, S W Moore

  • 1Department of Anesthesiology and Pediatric Surgery, University of Stellenbosch, Medical School, Tygerberg, South Africa.

Regional Anesthesia
|July 1, 1994
PubMed
Summary

Repeated spinal anesthesia using microcatheters provided effective operative anesthesia in young children. However, the risk of cerebrospinal fluid leaks contraindicates their use for postoperative pain relief.

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Area of Science:

  • Pediatric Anesthesiology
  • Neurosurgery
  • Pain Management

Background:

  • Standard single-dose spinal anesthesia is established for pediatric patients.
  • Subarachnoid microcatheter techniques offer potential for expanded spinal anesthesia applications.

Purpose of the Study:

  • To evaluate the efficacy and safety of repeated neuroblock via spinal catheters in pediatric patients undergoing prolonged major abdominal surgery.
  • To assess the feasibility of using subarachnoid microcatheters for adjunct operative anesthesia in children under five years.

Main Methods:

  • Ten children under five years received repeated spinal anesthesia via 28-gauge microcatheters.
  • General anesthesia with isoflurane was administered.
  • Bupivacaine was administered incrementally based on physiological response, with neurologic assessments performed post-procedure.

Main Results:

  • Catheter placement and removal were uncomplicated.
  • Surgical conditions and intraoperative analgesia were excellent, maintaining cardiovascular stability.
  • A cerebrospinal fluid leak occurred in three patients with catheters in situ for postoperative analgesia.

Conclusions:

  • Subarachnoid microcatheter technique is effective for adjunct operative anesthesia in infants and small children.
  • The risk of cerebrospinal fluid leaks, infection, and fistula formation contraindicates the use of these catheters for postoperative analgesia in this population.

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