{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:37:08Z","timestamp":1762508228242,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T00:00:00Z","timestamp":1602720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The use of spinal anesthesia in infants is seeing resurgence as an alternative to general anesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Our primary aims are to describe our institution's experience introducing a spinal anesthesia and sedation protocol for infants undergoing urologic surgery, to describe methods of improving prolonged anesthesia, and to describe the failure rate of spinal anesthesia in these patients. Sedation was provided for some infants with intranasal dexmedetomidine\u00a0\u00b1\u00a0fentanyl.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective case series examining infants aged 1\u2010&lt;14\u00a0months who received spinal anesthesia for circumcision, orchiopexy, orchiectomy, hypospadias repair, or epispadias repair. The electronic medical record was reviewed and compared with unmatched historical controls who received general anesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 230 patients underwent a urologic procedure; 102 patients received spinal anesthesia and 128 received general anesthesia. Length of surgical time with spinal anesthesia ranged from 4 to 189\u00a0minutes. The hospital length of stay was shorter in the spinal anesthesia group (median [IQR] of 5.3\u00a0hours [4.3, 7.2]) compared to the general anesthesia group (17.1\u00a0hours [15.6, 17.5]).The median bupivacaine dose was 0.75\u00a0mg\/kg [0.67, 0.85]. There was one case in which cerebral spinal fluid was unable to be obtained, and one case that required conversion to general anesthesia after surgery had started. There were no cases of apnea, bleeding, infection, or neurologic compromise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We describe the successful implementation of an infant spinal anesthesia and sedation protocol and a technique that uniquely provides prolonged surgical anesthesia with a low failure rate. We also report shorter anesthesia time, surgical time, and recovery room length of stay in patients who received spinal anesthesia compared to general anesthesia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14024","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T19:49:33Z","timestamp":1600890573000},"page":"1355-1362","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["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"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5456-3453","authenticated-orcid":false,"given":"Kathryn","family":"Handlogten","sequence":"first","affiliation":[{"name":"Department of Perioperative Medicine and Anesthesia Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1473-7084","authenticated-orcid":false,"given":"Lindsay","family":"Warner","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Anesthesia Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candace","family":"Granberg","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricio","family":"Gargollo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leanne","family":"Thalji","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Anesthesia Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawit","family":"Haile","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Anesthesia Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"570","article-title":"report of twelve operations on infants and young children during spinal anesthesia","volume":"18","author":"Bainbridge A","year":"1901","journal-title":"Arch Pediatr"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2017.06.006"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000709"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32485-1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-198403000-00015"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000708"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000093229.17729.6C"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2005.01664.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-1623"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ntt.2017.01.001"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev226"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2010.02.018"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198804000-00020"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2003.00972.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200509000-00008"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2007.02194.x"},{"issue":"2","key":"e_1_2_9_18_1","first-page":"211","article-title":"The European Society of Regional Anaesthesia and Pain Therapy\/American Society of Regional Anesthesia and pain medicine recommendations on local anesthetics and adjuvants dosage in pediatric regional anesthesia","volume":"43","author":"Suresh S","year":"2018","journal-title":"Reg Anesth Pain Med"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/ael156"},{"issue":"11","key":"e_1_2_9_20_1","first-page":"42","article-title":"ICU data mart: a non\u2010iT approach. 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