Implementation of a spinal anesthesia and sedation protocol that reliably prolongs infant spinal anesthesia: Case series of 102 infants who received spinal anesthesia for urologic surgery

2020 ◽  
Vol 30 (12) ◽  
pp. 1355-1362
Author(s):  
Kathryn Handlogten ◽  
Lindsay Warner ◽  
Candace Granberg ◽  
Patricio Gargollo ◽  
Leanne Thalji ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Case Series ◽  
Urologic Surgery ◽  
Sedation Protocol

scholarly journals Open Appendicectomy under Spinal Anesthesia—A Valuable Alternative during COVID-19

2021 ◽  
Vol 07 (02) ◽  
pp. e69-e72
Author(s):  
Dinh Van Chi Mai ◽  
Alex Sagar ◽  
Oliver Claydon ◽  
Ji Young Park ◽  
Niteen Tapuria ◽  
...  
Keyword(s):  
United Kingdom ◽  
Patient Satisfaction ◽  
Spinal Anesthesia ◽  
Stated Preference ◽  
Case Series ◽  
District General Hospital ◽  
Complication Rates ◽  
Open Appendicectomy ◽  
Surgical Department ◽  
The United Kingdom

Abstract Introduction Concerns relating to coronavirus disease 2019 (COVID-19) and general anesthesia (GA) prompted our department to consider that open appendicectomy under spinal anesthesia (SA) avoids aerosolization from intubation and laparoscopy. While common in developing nations, it is unusual in the United Kingdom. We present the first United Kingdom case series and discuss its potential role during and after this pandemic. Methods We prospectively studied patients with appendicitis at a British district general hospital who were unsuitable for conservative management and consequently underwent open appendicectomy under SA. We also reviewed patient satisfaction after 30 days. This ran for 5 weeks from March 25th, 2020 until the surgical department reverted to the laparoscopic appendicectomy as the standard of care. Main outcomes were 30-day complication rates and patient satisfaction. Results None of the included seven patients were COVID positive. The majority (four-sevenths) had complicated appendicitis. There were no major adverse (Clavien-Dindo grade III to V) postoperative events. Two patients suffered minor postoperative complications. Two experienced intraoperative pain. Mean operative time was 44 minutes. Median length of stay and return to activity was 1 and 14 days, respectively. Although four stated preference in hindsight for GA, the majority (five-sevenths) were satisfied with the operative experience under SA. Discussion Although contraindications, risk of pain, and specific complications may be limiting, our series demonstrates open appendicectomy under SA to be safe and feasible in the United Kingdom. The technique could be a valuable contingency for COVID-suspected cases and patients with high-risk respiratory disease.

The Use of Bupivacaine and Fentanyl for Spinal Anesthesia for Urologic Surgery

2000 ◽  
Vol 91 (6) ◽  
pp. 1452-1456 ◽  
Author(s):  
Kristiina S. Kuusniemi ◽  
Kalevi K. Pihlajamäki ◽  
Mikko T. Pitkänen ◽  
Hans Y. Helenius ◽  
Olli A. Kirvelä
Keyword(s):  
Spinal Anesthesia ◽  
Urologic Surgery

scholarly journals A Conscious Sedation Protocol for Videolaryngostroboscopy in Pediatric Patients

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Samantha Anne ◽  
Lawrence M. Borland ◽  
Laura Haibeck ◽  
Joseph E. Dohar
Keyword(s):  
Outcome Measures ◽  
Pediatric Patients ◽  
Conscious Sedation ◽  
Treatment Plan ◽  
Tertiary Care ◽  
Case Series ◽  
Diagnostic Information ◽  
Secondary Outcome ◽  
Sedation Protocol

Objective. To determine best sedation protocol for videolaryngostroboscopy in children unable to tolerate non-sedated evaluation.Materials and Methods.Consecutive case series of 10 children with voice disturbances, unable to tolerate nonsedated videolaryngostroboscopy at an academic tertiary care children’s hospital. Flexible fiberoptic videolaryngostroboscopy was performed and interpreted by pediatric otolaryngologist and speech and language pathologist. Sedation was administered with newly described protocol that allowed functional portion of evaluation.Main Outcome Measures: ability to follow commands and tolerate flexible fiberoptic videolaryngostroboscopy.Secondary Outcome Measures: total phonation time, complications, need for subsequent videolaryngostroboscopic attempts, clinical outcomes, and follow-up.Results. 10 children underwent procedure under conscious sedation. 9/10 children were able to perform simple tasks and maintain adequate phonation time to complete stroboscopic exam. 1/10 patients failed to complete exam because of crying during entire exam. Mean exam time was 2 minutes 52 seconds (SD 86 seconds), phonation time is 1 minute 44 seconds (SD 60 seconds), and number of tasks completed was 10.5 (SD 8.6).Conclusions. Conscious sedation for videolaryngostroboscopy can be safely and effectively performed in children unable to comply with nonsedated examination. Such studies provide valuable diagnostic information to make a diagnosis and to devise a treatment plan.

Low-Dose Spinal Anesthesia with Hyperbaric Bupivacaine with Intrathecal Fentanyl for Operative Hysteroscopy: A Case Series Study

2012 ◽  
Vol 19 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Pasquale Florio ◽  
Rosa Puzzutiello ◽  
Marco Filippeschi ◽  
Pasquale D’Onofrio ◽  
Liliana Mereu ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Low Dose ◽  
Case Series ◽  
Hyperbaric Bupivacaine ◽  
Operative Hysteroscopy ◽  
Case Series Study ◽  
Series Study

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

2016 ◽  
Vol 7 (11) ◽  
pp. 493-497
Author(s):  
Alexander B. Froyshteter ◽  
Emmett E. Whitaker ◽  
Jason A. Bryant ◽  
Christina B. Ching ◽  
Joseph D. Tobias
Keyword(s):  
Spinal Anesthesia ◽  
Single Ventricle ◽  
Single Ventricle Physiology ◽  
Urologic Surgery

Effect of Benson Relaxation on the Intensity of Spinal Anesthesia–Induced Pain After Elective General and Urologic Surgery

2019 ◽  
Vol 34 (6) ◽  
pp. 1232-1240 ◽  
Author(s):  
Zahra Keihani ◽  
Rostam Jalali ◽  
Mohammad Bagher Shamsi ◽  
Nader Salari
Keyword(s):  
Spinal Anesthesia ◽  
Urologic Surgery

Benefits of spinal anesthesia for urologic surgery in the youngest of patients

2019 ◽  
Vol 15 (1) ◽  
pp. 49.e1-49.e5 ◽  
Author(s):  
K.M. Ebert ◽  
V.R. Jayanthi ◽  
S.A. Alpert ◽  
C.B. Ching ◽  
D.G. DaJusta ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Urologic Surgery

scholarly journals A novel way of Subfoveal Perfluorocarbon liquid Removal using 26 gauge spinal anesthesia needle

2020 ◽  
Vol 12 (1) ◽  
pp. 119-124
Author(s):  
Abhishek Anand ◽  
Lalit Agarwal ◽  
Nisha Agrawal
Keyword(s):  
Spinal Anesthesia ◽  
Silicone Oil ◽  
Case Series ◽  
Cost Effective ◽  
Nerve Fibers ◽  
Complete Restoration ◽  
Pars Plana ◽  
Liquid Removal ◽  
Sd Oct

Introduction: Perfluorocarbon (PFCL) is an essential adjunct of retinal detachment surgery. Subfoveal migration of PFCL is a rare and vision threatening complication of its use. Various techniques have been described for its removal. However, no consensual technique of its removal has been established. We present a nova, relatively atraumatic and cost effective way of PFCL removal using a widely available 26G spinal anesthesia needle. Case: An 18 years old myopic patient who had undergone left eye pars plana vitrectomy (PPV) for myopic Rhegmatogenous Retinal Detatchment (RRD) in the past presented after 1 month with retained subfoveal PFCL. Its subretinal location was confirmed by Optical Coherence Tomography (OCT). He was taken up for early Silicone Oil Removal (SOR) along with removal of retained subfoveal PFCL under high magnification by using a surgical disposable contact macula lens. A 26G spinal anesthesia needle tip was used to dissect a small separation parallel to the nerve fibers at the temporal edge of tense cystic PFCL bleb. Silicone tipped flute cannula was used to passively aspirate the sub retinal PFCL under fluid with no additional intervention. No barrage LASER was done. Observation: Anatomical restoration of the retina was noted both intraoperatively and post-operatively. SD-OCT showed complete restoration of anatomical layers with no presence of intraretinal cystic cleft both at day 1 and 30 days postoperatively. Conclusion: Safe removal of subfoveal PFCL can be done with 26G spinal anesthesia needle which is atraumatic, inexpensive and readily available. However, long term validity of this process needs to be established in a case series.

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