Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA; Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
J Pediatr Surg. 2024 Jun;59(6):1148-1153. doi: 10.1016/j.jpedsurg.2024.02.001. Epub 2024 Feb 10.
To perform a single institution review of spinal instead of general anesthesia for pediatric patients undergoing surgical procedures. Spinal success rate, intraoperative complications, and postoperative outcomes including unplanned hospital admission and emergency department visits within seven days are reported.
Retrospective chart review of pediatric patients who underwent spinal anesthesia for surgical procedures from 2016 until 2022. Data collected included patient demographics, procedure and anesthetic characteristics, intraoperative complications, unplanned admissions, and emergency department returns.
The study cohort included 1221 patients. Ninety-two percent of the patients tolerated their surgical procedure without requiring conversion to general anesthesia, and 78% of patients that had spinals placed successfully did not receive any sedation following lumbar puncture. The most common intraoperative event was systolic blood pressure below 60 mm Hg (14%), but no cases required administration of vasoactive agents, and no serious intraoperative adverse events were observed. Post-Anesthesia Care Unit Phase I was bypassed in 72% of cases with a median postoperative length of stay of 84 min. Forty-six patients returned to the emergency department following hospital discharge, but no returns were due to anesthetic concerns.
Spinal anesthesia is a viable and versatile option for a diversity of pediatric surgical procedures. We noted a low incidence of intraoperative and postoperative complications. There remain numerous potential advantages of spinal anesthesia over general anesthesia in young pediatric patients particularly in the ambulatory setting.
IV.
Retrospective cohort treatment study.
对一家机构内接受手术的儿科患者采用椎管内麻醉而非全身麻醉的情况进行回顾性研究。报告椎管内麻醉的成功率、术中并发症和术后结果，包括术后 7 天内的非计划住院和急诊就诊。
对 2016 年至 2022 年期间接受椎管内麻醉进行手术的儿科患者进行回顾性病历分析。收集的数据包括患者人口统计学、手术和麻醉特征、术中并发症、非计划住院和急诊就诊。
研究队列包括 1221 名患者。92%的患者在手术过程中无需转为全身麻醉即可耐受，78%的成功进行椎管内麻醉的患者在腰椎穿刺后无需接受任何镇静治疗。最常见的术中事件是收缩压低于 60mmHg（14%），但没有需要使用血管活性药物的病例，也没有观察到严重的术中不良事件。72%的患者在麻醉后恢复室（PACU）第 1 阶段被跳过，术后中位住院时间为 84 分钟。46 名患者在出院后返回急诊，但没有因麻醉问题返回。
椎管内麻醉是一种可行且多样化的儿科手术麻醉选择。我们发现术中及术后并发症的发生率较低。在小儿患者中，椎管内麻醉相对于全身麻醉具有许多潜在优势，尤其是在门诊环境中。
IV.
回顾性队列治疗研究。
