Chiao Franklin, Boretsky Karen
From the Department of Anesthesiology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York.
Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital-Harvard Medical School, Boston, Massachusetts.
A A Pract. 2019 Mar 1;12(5):168-170. doi: 10.1213/XAA.0000000000000876.
Spinal anesthesia (SA) is a valuable alternative to general anesthesia in infants, but laparoscopic surgery is considered a contraindication in this age group. We report 3 cases of SA for inguinal hernia repairs. The contralateral inguinal region was explored by laparoscopic port placement and pneumoperitoneum through the surgical site. Ages ranged from 5 to 15 weeks, postconceptual age from 46 to 55 weeks, and weights from 4.0 to 6.6 kg. Spinal anesthetics were supplemented with intravenous dexmedetomidine. One patient experienced hypertension and tachycardia during insufflation with brief supplemental use of sevoflurane. Opioids were spared in 2 patients. Pain scores were low throughout. SA as a primary anesthetic may be used in pediatric laparoscopic procedures.
脊髓麻醉（SA）是婴儿全身麻醉的一种有价值的替代方法，但腹腔镜手术在这个年龄组被认为是禁忌。我们报告3例脊髓麻醉用于腹股沟疝修补术的病例。通过手术部位放置腹腔镜端口并建立气腹来探查对侧腹股沟区域。年龄范围为5至15周，孕龄为46至55周，体重为4.0至6.6千克。脊髓麻醉辅以静脉注射右美托咪定。1例患者在充气时出现高血压和心动过速，短暂辅助使用了七氟醚。2例患者未使用阿片类药物。整个过程疼痛评分较低。脊髓麻醉作为主要麻醉方法可用于小儿腹腔镜手术。
