Our Summary

This research paper discusses the use of spinal anesthesia in infants and toddlers during surgery. The paper argues that this type of anesthesia is safe and can prevent complications during and after surgery, such as breathing problems and heart instability. It can also help to speed up recovery time, allowing the child to leave the operating room and eat more quickly after surgery.

The paper presents a case study of a baby who was born prematurely and underwent a type of surgery called a laparoscopic inguinal hernia repair, where a hernia in the groin area is fixed. This was done using spinal anesthesia and the baby remained calm and stable throughout the procedure and recovery period.

The research suggests that spinal anesthesia could be a good option for this type of surgery when the pressure in the abdomen (caused by inflating it to make the surgery easier) and the length of the operation are kept to certain limits. Also, it works best when the anesthesia is administered at a certain level in the spine or higher.

FAQs

  1. Is spinal anesthesia safe and practical for infants and toddlers undergoing pediatric hernia repair?
  2. What are the advantages of using spinal anesthesia during pediatric hernia repair?
  3. Is spinal anesthesia feasible for laparoscopic herniotomy in infants and toddlers?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric hernia repair is to ask about the possibility of using spinal anesthesia for the procedure. Spinal anesthesia can be practical and safe for infants and toddlers undergoing hernia repair, and it can help prevent perioperative complications. Discussing this option with the surgical team can help ensure a smooth and successful procedure for your child.

Suitable For

Pediatric patients who are typically recommended for pediatric hernia repair include infants and toddlers with inguinal hernias. In the case presented in the article, the patient was an ex-premature infant who underwent laparoscopic inguinal hernia repair. Spinal anesthesia was used as it was found to be practical and safe in this age group, providing perioperative advantages such as reduced time from surgery completion to operating room exit and first feed. Spinal anesthesia may be considered for laparoscopic herniotomy in pediatric patients when certain criteria are met, such as restricting pneumoperitoneum pressure and operative time and achieving a sensory level at T10 or higher.

Timeline

  • Before pediatric hernia repair:
  1. Consultation with a pediatric surgeon to diagnose and assess the hernia
  2. Preoperative evaluation and preparation, including fasting and anesthesia consultation
  3. Admission to the hospital on the day of surgery
  4. Administration of anesthesia before the procedure, potentially including spinal anesthesia
  5. Laparoscopic inguinal hernia repair procedure
  • After pediatric hernia repair:
  1. Recovery in the post-anesthesia care unit (PACU) under close monitoring
  2. Pain management and monitoring for any complications
  3. Gradual return to normal activities and diet
  4. Discharge from the hospital once the patient is stable and able to tolerate oral intake
  5. Follow-up appointments with the surgeon to monitor healing and recovery

Overall, pediatric hernia repair with spinal anesthesia can offer a safe and effective method of pain management for young patients, with potential benefits in terms of perioperative complications and recovery time.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric hernia repair surgery?
  2. What is the success rate of laparoscopic hernia repair in children?
  3. How long will the recovery process take after pediatric hernia repair surgery?
  4. Are there any specific restrictions or guidelines that need to be followed during the recovery period?
  5. How soon after the surgery can the child resume normal activities, such as school or sports?
  6. Are there any long-term effects or complications that may arise from pediatric hernia repair surgery?
  7. What is the expected outcome or prognosis for a child undergoing hernia repair surgery?
  8. What are the alternatives to surgical treatment for pediatric hernias?
  9. How experienced is the medical team in performing pediatric hernia repair surgeries?
  10. Are there any specific preoperative or postoperative instructions that need to be followed for a successful outcome?

Reference

Authors: Eizaga Rebollar R, García Palacios MV, Morales Guerrero J, Torres Morera LM. Journal: A A Pract. 2018 Dec 1;11(11):293-295. doi: 10.1213/XAA.0000000000000810. PMID: 29851688