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Critical tips and questions on pediatric spinal anaesthesia

  • Seza Senturk Apiliogulari
    Correspondence
    Correspondence to: Seza Senturk Apiliogullari, Canakkale Onsekiz Mart University, School of Medicine, Department of Anesthesia and Intensive Care, 17110, Canakkale, Turkey, Tel.: +905054887014.
    Affiliations
    Canakkale Onsekiz Mart University, School of Medicine, Department of Anesthesia and Intensive Care, 17110, Canakkale, Turkey
    Search for articles by this author
  • Melih Aktas
    Affiliations
    Canakkale Onsekiz Mart University, School of Medicine, Department of Anesthesia and Intensive Care, 17110, Canakkale, Turkey
    Search for articles by this author
Published:January 12, 2023DOI:https://doi.org/10.1016/j.jpurol.2022.12.020
      We read with much interest the recent retrospective study titled “Spinal anesthesia in infants undergoing urologic surgery duration greater than 60 min” by Jefferson et al. [
      • Jefferson F.A.
      • Findlay B.L.
      • Handlogten K.S.
      • Gargollo P.C.
      • Warner L.L.
      • Woodbury J.M.
      • et al.
      Spinal anesthesia in infants undergoing urologic surgery duration greater than 60 minutes.
      ] performed in Mayo Clinic.
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      References

        • Jefferson F.A.
        • Findlay B.L.
        • Handlogten K.S.
        • Gargollo P.C.
        • Warner L.L.
        • Woodbury J.M.
        • et al.
        Spinal anesthesia in infants undergoing urologic surgery duration greater than 60 minutes.
        J Pediatr Urol. 2022; 14 (1477-5131(22)00304-7. https://doi.org/10.1016/j.jpurol.2022.07.003)
        • Apiliogullari S.
        • Duman A.
        Is spinal anesthesia not enough for major abdominal procedures of neonates?.
        Paediatr Anaesth. 2008; 18: 1219https://doi.org/10.1111/j.1460-9592.2008.02701.x
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        Iatrogenic epidermoid tumor: late complication of lumbar puncture.
        J Child Neurol. 2007; 22: 332-336https://doi.org/10.1177/0883073807300531
        • Apiliogullari S.
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        • Akillioglu I.
        Spinal needle design and size affect the incidence of postdural puncture headache in children.
        Paediatr Anaesth. 2010; 20: 177-182https://doi.org/10.1111/j.1460-9592.2009.03236.x
        • Kokki H.
        • Hendolin H.
        • Turunen M.
        Postdural puncture headache and transient neurologic symptoms in children after spinal anaesthesia using cutting and pencil point paediatric spinal needles.
        Acta Anaesthesiol Scand. 1998; 42: 1076-1082https://doi.org/10.1111/j.1399-6576.1998.tb05379.x

      Linked Article

      • Response to letter to the editor
        Journal of Pediatric Urology
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          It is our standard to perform lumbar puncture for diagnostic and spinal anesthesia with the stylet in the needle and only remove it when we think we have punctured the dura. If CSF does not drip, we re-stylet until we check again for CSF drip. It would be rare to maneuver the needle without stylet unless we are already in the intrathecal space. We use a needle with a stylet to prevent the carving of the epidermis or dermis, plugging the needle, and not seeing quick CSF drip when the needle is in the intrathecal space.
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