Spinal anesthesia for diagnostic cardiac catheterization in high-risk infants

  1. Rita Katznelson MD1,
  2. David Mishaly MD2,
  3. Theodor Hegesh MD2,
  4. Azriel Perel MD1,
  5. Ilan Keidan MD1

Article first published online: 13 OCT 2004

DOI: 10.1111/j.1460-9592.2004.01393.x

Issue

Pediatric Anesthesia

Pediatric Anesthesia

Volume 15, Issue 1, pages 50–53, January 2005

Additional Information

How to Cite

Katznelson, R., Mishaly, D., Hegesh, T., Perel, A. and Keidan, I. (2005), Spinal anesthesia for diagnostic cardiac catheterization in high-risk infants. Pediatric Anesthesia, 15: 50–53. doi: 10.1111/j.1460-9592.2004.01393.x

Author Information

  1. 1

    Pediatric Anesthesia Division, Department of Anesthesia and Intensive Care

  2. 2

    Pediatric Cardiology Division, Department of Pediatrics, Sheba Medical Center, Tel Hashomer (affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv), Israel

*Ilan Keidan, Pediatric Anesthesia Division, Department of Anesthesia and Intensive Care, Sheba Medical Center, Tel-Hashomer 52621, Israel (email: keidan@012.net.il).

Publication History

  1. Issue published online: 13 OCT 2004
  2. Article first published online: 13 OCT 2004
  3. Accepted 7 March 2004

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Keywords:

  • spinal anesthesia;
  • cardiac catheterization;
  • infant

Summary

Background : The main goals of diagnostic cardiac catheterization (DCC) in infants are to evaluate the anatomy and physiology of congenital and acquired cardiac defects while maintaining normal respiratory and hemodynamic variables. The aims of anesthesia for infants undergoing DCC are to prevent pain and movement during the procedure. General anesthesia (GA) or deep sedation could have undesirable respiratory and hemodynamic effects for conducting such studies. Furthermore, GA is associated with increased risks, especially in high-risk infants. Spinal anesthesia (SA) is a successful alternative to GA in surgery on infants with a history of prematurity and respiratory problems, with minimal respiratory and hemodynamic changes.

Methods : We studied whether those advantages were applicable to DCC, and used a predetermined SA protocol in a cohort of 12 infants with compromised respiratory status. Success rate, study completion, complications, hemodynamic and respiratory effects and recovery profile were recorded.

Results : Failure rate was significantly higher in infants older than 6 months. There was no significant difference between baseline and intraprocedure hemodynamic and respiratory parameters. The time to discharge was relatively short (33 ± 12 min).

Conclusions : Spinal anesthesia apparently provides stable hemodynamics and respiratory variables, rapid recovery and discharge time, and may be a viable alternative to GA or deep sedation in high-risk infants <6 months old undergoing DCC.

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