An evaluation of spinal anesthesia results in pediatric patients undergoing pilonidal sinus surgery: a retrospective study

Year 2023, , 1210 - 1214, 29.10.2023

Sevda Akdeniz

https://doi.org/10.32322/jhsm.1355839

Abstract

Aims: The aim of this retrospective study was to evaluate the efficacy, side-effects, and complications of spinal anesthesia (SpA) in children undergoing pilonidal sinus surgery with SpA.
Methods: The records of pediatric patients who underwent pilonidal sinus surgery with SpA from January 2019 to March 2023 were retrospectively evaluated from the database in the Samsun University Samsun Maternity & Children's Training and Research Hospital, Department of Anesthesiology and Reanimation, Türkiye. Children's sociodemographic characteristics, clinical and vital signs, motor block duration, operative time, and complications were recorded.
Results: Eighty-one patients underwent pilonidal sinus surgery with SpA, 54 (66.7%) boys and 27 (33.3%) girls, with a mean age of 14.38±1.29 years. The patients’ mean body mass index was 26.83±1.1 kg.m-2, and the success rate was 96.3% (n=78). Eleven (13.6%) patients received supplemental anesthesia among the 78 procedures completed using SpA. The incidence of complications was 5.1% (n=4). Intraoperative hypotension developed in two cases and postoperative vomiting in two, all of which resolved with no sequelae.
Conclusion: Our retrospective analysis suggests that pediatric SpA is a safe and effective technique for children undergoing pilonidal sinus surgery. However, further prospective studies are warranted to confirm these findings.

Keywords

Anesthesia, children, spinal anesthesia, surgery, pilonidal sinus

References

• Neal JM, Bernards CM, Hadzic A, et al. ASRA practice advisory on neurologic complications in regional anesthesia and pain medicine. Reg Anesth Pain Med. 2008;33(5):404-415.
• Williams RK, Adams DC, Aladjem EV, et al. The safety and efficacy of spinal anesthesia for surgery in infants: the Vermont Infant Spinal Registry. Anesth Anal. 2006;102(1):67-71.
• Eizaga Rebollar R, García Palacios MV, Morales Guerrero J, Torres Morera LM. Pediatric spinal anesthesia at a tertiary care hospital: eleven years after. Paediatr Anaesth. 2022;32(5):617-624.
• Rivera-Calonje F, Chen SE, Lo C, Le S, Nagoshi M. Urgent surgery for COVID-19-positive pediatric patient. JA Clin Rep. 2021;7(1):57.
• Rehfuss A, Bogaert G, Kogan B. Spinal anesthesia in children: most pediatric urologists are not on board. J Pediatr Urol. 2019;15(3): 263.e1-263.e5.
• Disma N, Clunies-Ross N, Chalkiadis GA. Is spinal anaesthesia in young infants really safer and better than general anaesthesia? Curr Opin Anaesthesiol. 2018;31(3):302-307.
• Whitaker EE, Wiemann BZ, Dajusta DG, et al. Spinal anesthesia for pediatric urological surgery: reducing the theoretic neurotoxic effects of general anesthesia. J Pediatr Urol. 2017;13(4):396-400.
• Qiao H, Chen J, Lv P, et al. Efficacy of premedication with intravenous midazolam on preoperative anxiety and mask compliance in pediatric patients: a randomized controlled trial. Transl Pediatr. 2022;11(11):1751-1758.
• Bromage PR. A comparison of the hydrochloride and carbon dioxide salts of lidocaine and prilocaine in epidural analgesia. Acta Anaesthesiol Scand Suppl. 1965;16:55-69.
• Santana L, Kiebzak GM, Toomey N, Maul TM. Blood pressure measurements during intraoperative pediatric scoliosis surgery. Saudi J Anaesth. 2020;14(2):152-156.
• Gupta A, Saha U. Spinal anesthesia in children: a review. J Anaesthesiol Clin Pharmacol. 2014;30(1):10-18.
• Caliskan E, Sener M, Kocum A, Bozdogan N, Arıbogan A. Our experiences with spinal anesthesia in pediatric patients. Agri. 2011;23(3):100-106.
• Kantekin CU, Yalvac M, Evran T, et al. Our experiences with spinal anesthesia in 143 pediatric patients. Turkiye Klinikleri J Anest Reanim. 2015;13(1):25-29.
• Baltrak YA, Soyalp C. Spinal anestezi ile appendektomi yapılan çocuk hastalarda tek merkez deneyimlerinin değerlendirilmesi. Med Res Rep. 2019;2(1):23-27.
• Kokki H, Turunen M, Heikkinen M, Reinikainen M, Laisalmi M. High success rate and low incidence of headache and neurological symptoms with two spinal needle designs in children. Acta Anaesthesiol Scand. 2005;49(9):1367-1372.
• Imbelloni LE, Vieira EM, Sperni F, Guizellini RH, Tolentino AP. Spinal anesthesia in children with isobaric local anesthetics: report on 307 patients under 13 years of age. Paediatr Anaesth. 2006;16(1):43-48.
• Lopez T, Sanchez FJ, Garzon JC, Muriel C. Spinal anesthesia in pediatric patients. Minerva Anestesiol. 2012;78(1):78-87.
• Vilà R, Lloret J, Munar F, Vinzo J. Spinal anaesthesia for inguinal herniotomy in preterm infants sedated with nitrous oxide: a comparison of lumbar puncture in the lateral or sitting position. Anaesthesia. 2002;57(12):1164-1167.
• Kokki H, Ylönen P, Laisalmi M, Heikkinen M, Reinikainen M. Isobaric ropivacaine 5 mg/ml for spinal anesthesia in children. Anesth Analg. 2005;100(1):66-70.
• Lönnqvist PA, Ecoffey C, Bosenberg A, Suresh S, Ivani G. The European society of regional anesthesia and pain therapy and the American society of regional anesthesia and pain medicine joint committee practice advisory on controversial topics in pediatric regional anesthesia I and II: what do they tell us?. Curr Opin Anaesthesiol. 2017;30(5):613-620.