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Laparoscopic Surgery in Infants Under Spinal Anesthesia Block

A Case Report of 3 Cases

Chiao, Franklin, MD*; Boretsky, Karen, MD

doi: 10.1213/XAA.0000000000000876
Case Reports

Spinal anesthesia (SA) is a valuable alternative to general anesthesia in infants, but laparoscopic surgery is considered a contraindication in this age group. We report 3 cases of SA for inguinal hernia repairs. The contralateral inguinal region was explored by laparoscopic port placement and pneumoperitoneum through the surgical site. Ages ranged from 5 to 15 weeks, postconceptual age from 46 to 55 weeks, and weights from 4.0 to 6.6 kg. Spinal anesthetics were supplemented with intravenous dexmedetomidine. One patient experienced hypertension and tachycardia during insufflation with brief supplemental use of sevoflurane. Opioids were spared in 2 patients. Pain scores were low throughout. SA as a primary anesthetic may be used in pediatric laparoscopic procedures.

From the *Department of Anesthesiology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York

Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital-Harvard Medical School, Boston, Massachusetts.

Accepted for publication July 17, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Franklin Chiao, MD, Department of Anesthesiology, New York Presbyterian Hospital-Weill Cornell Medical College, 525 E 68th St, A1005, New York, NY 10065. Address e-mail to

© 2019 International Anesthesia Research Society
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