Spinal Anaesthesia for Paediatric Surgery

Abstract

Paediatric anaesthesia represents a real challenge that requires a lot of skill to be perfectly managed.

The physiological and anatomical differences combined with the immaturity of most systems and the high incidence of congenital malformation, all these necessitate an anaesthesiologist who is fully aware with their problems.

Regional anaesthesia provides a perfect solution for many problems that we face in our practice of anaesthesia for the paediatric age group, e.g. how to minimize respiratory depression in a preterm infant or how to maintain a child fully conscious for a day-care surgery, or what is the ideal method for post-operative pain control in a helpless child.

Spinal anaesthesia, after a century with proven efficiency and safety, is still of limited use in our practice of paediatric anaesthesia.

The great cardiovascular stability and minimal incidence of respiratory depression, together a much lower incidence of post­ lumbar puncture headache compared to adults, push this technique to a front line when considering a regional technique for anaesthetizing a child.

The main hindrance we face in our practice of paediatric spinal anaesthesia is the limited experience and unfamiliarity with the technique. Both are temporary obstacles that will disappear with the performance of enough studies to confirm the safety and efficacy and to establish the use of new drugs in the proper dosage.