Spinal anesthesia for pediatrics

Spinal anesthesia for pediatrics first appeared at the beginning of 20th century. After an initial period of disuse, it has now gained popularity due to its favorable characteristics such as cardiovascular stability in children less than 5 years of age; satisfactory analgesia and muscle relaxation; the possibility of performing surgical procedures in patients at risk for general anesthesia (ie, formerly preterm infants at risk for postoperative apnea); and the ability to administer small doses of local anesthetic (preferably hyperbaric tetracaine or bupivacaine) with consequent reduced toxic effects. This technique is limited mainly by a relatively short duration of anesthesia (surgical procedures generally cannot last more than 90 min), by the absence of satisfactory postoperative pain control, and obviously by the lack of experience of anesthetist. Postdural puncture headache is rare. Although this technique could appear to be less invasive, we recommend an accurate postoperative control for at least 12 hours.