Our Summary

This research paper discusses a study conducted on the use of spinal anesthesia (SA) as an alternative to general anesthesia (GA) in children undergoing urological surgery. The study was conducted at a large pediatric centre and data was collected on all children undergoing SA.

The researchers found that they could successfully perform SA on 89% of the 105 children involved in the study. In 7% of cases, they couldn’t get the spinal fluid they needed to administer the anesthesia, so they had to use GA instead. In 5% of the cases where they initially used SA, they had to switch to GA during the surgery due to complications.

Overall, they were able to use SA without having to switch to GA in 84% of cases. Most of these children didn’t need any additional sedation or anesthetic agents. The average time to administer SA was about 4 minutes, and the average surgery time was about 38 minutes.

The study concluded that SA is a safe and effective technique for routine pediatric urological procedures, and should be considered as an option in cases where GA poses significant risks.

FAQs

  1. What was the success rate of administering spinal anesthesia (SA) to children in this study?
  2. In what percentage of cases did the researchers have to switch from SA to general anesthesia (GA) during surgery due to complications?
  3. Did the study conclude that SA is a safe and effective technique for routine pediatric urological procedures?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal surgery is to follow all pre-operative instructions provided by the surgical team. This may include fasting before surgery, stopping certain medications, and avoiding smoking or alcohol. By following these instructions, the patient can help reduce the risk of complications during and after the surgery.

Suitable For

Patients who are typically recommended for spinal surgery include those with severe and persistent back pain that has not responded to conservative treatments such as physical therapy, medications, and injections. Other indications for spinal surgery may include:

  1. Degenerative disc disease: Patients with degenerative changes in the discs of the spine, such as herniated discs or spinal stenosis, may benefit from spinal surgery to alleviate pressure on the nerves and relieve pain.

  2. Spinal deformities: Conditions such as scoliosis, kyphosis, and spondylolisthesis may require spinal surgery to correct the alignment of the spine and prevent further progression of the deformity.

  3. Spinal fractures: Patients with unstable spinal fractures, such as those caused by trauma or osteoporosis, may need spinal surgery to stabilize the spine and prevent neurological complications.

  4. Spinal tumors: Patients with benign or malignant tumors in the spine may require surgery to remove the tumor and prevent further damage to the spinal cord and nerves.

  5. Failed back surgery syndrome: Patients who have undergone previous spinal surgery but continue to experience persistent pain or new symptoms may be recommended for revision surgery to address the underlying cause of their symptoms.

  6. Spinal infections: Patients with spinal infections, such as spinal abscess or meningitis, may require surgery to drain the infection and stabilize the spine.

It is important for patients to undergo a thorough evaluation by a spine specialist to determine if spinal surgery is the most appropriate treatment option for their specific condition. The decision to undergo spinal surgery should be made in consultation with a multidisciplinary team of healthcare providers, including orthopedic surgeons, neurosurgeons, and pain management specialists.

Timeline

Timeline before spinal surgery:

  • Patient meets with their surgeon to discuss the procedure and to review the risks and benefits of surgery.
  • Patient undergoes pre-operative testing and evaluations to ensure they are healthy enough for surgery.
  • Patient may need to stop taking certain medications or adjust their diet before surgery.
  • Patient arrives at the hospital or surgical center on the day of surgery and is prepped for the procedure.

Timeline after spinal surgery:

  • Patient wakes up in the recovery room and is monitored closely for any complications.
  • Patient may experience some pain and discomfort at the surgical site, which is managed with pain medication.
  • Patient begins physical therapy and rehabilitation to help regain strength and mobility.
  • Patient is discharged from the hospital once their surgeon feels they are ready to go home.
  • Patient continues to follow up with their surgeon for post-operative appointments to monitor their progress and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal surgery include:

  1. What are the potential risks and complications associated with spinal surgery?
  2. What is the expected recovery time after spinal surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. How long will I need to stay in the hospital after the surgery?
  5. What type of anesthesia will be used during the surgery, and what are the potential side effects?
  6. What is the success rate of this type of spinal surgery?
  7. Are there any alternative treatments or procedures that could be considered instead of surgery?
  8. What is the experience of the surgical team in performing this specific type of spinal surgery?
  9. How long will it take for me to see improvements in my symptoms after the surgery?
  10. What are the long-term outcomes and potential complications associated with this type of spinal surgery?

Reference

Authors: Whitaker EE, Wiemann BZ, DaJusta DG, Alpert SA, Ching CB, McLeod DJ, Tobias JD, Jayanthi VR. Journal: J Pediatr Urol. 2017 Aug;13(4):396-400. doi: 10.1016/j.jpurol.2017.06.006. Epub 2017 Jul 14. PMID: 28818338