Spinal Anesthesia for Urologic Surgery in an Infant With Palliated Single Ventricle Physiology

Alexander B. Froyshteter, Emmett E. Whitaker, Jason A. Bryant, Christina B. Ching, Joseph D. Tobias

Abstract


Although commonly practiced in the adult population, spinal anesthesia has seen sporadic use in the pediatric population, being employed historically as a means of avoiding apnea following general anesthesia with halothane. With the emergence of evidence that specific anesthetic agents may affect future neurocognitive outcomes, there has been an increased focus on alternatives to general anesthesia, including spinal anesthesia.  However, spinal anesthesia may also have applications in patients with co-morbid conditions that increase the risk of general anesthesia. We present the use of spinal anesthesia during urologic surgery in a 19-month-old boy with hypoplastic left heart syndrome who had undergone surgical palliation. The use of spinal anesthesia in patients with congenital heart disease is reviewed, potential hemodynamic consequences are presented, and the use of spinal anesthesia as an alternative to general anesthesia is discussed.




J Med Cases. 2016;7(11):493-497
doi: https://doi.org/10.14740/jmc2673w

Keywords


Spinal anesthesia; Congenital heart disease; Hypoplastic left heart syndrome; Regional anesthesia

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