Spinal anesthesia (SA) in the child under two years old is an excellent option when undergoing short genitourinary procedures. The use of SA in this patient population can avoid the potential deleterious neurocognitive effects on the developing brain that general anesthesia (GA) poses. A comprehensive literature review was conducted via retrospective case study, case control study, integrated review, and prospective study. The objective of this literature review is to examine the potential long-term neurotoxic effects of GA in the infant, as well as the benefits of SA. GA in the younger population has been shown to produce lower gray matter density seen on magnetic resonance imaging, altered listening comprehension, and an increased risk of developing a learning disability later in childhood. Success of SA was defined as the absence of subsequent conversion to GA in multiple studies reviewed. Use of SA in this vulnerable population, as opposed to general anesthesia, resulted in better maintenance of hemodynamics, less perioperative opioid use, and a shorter post-anesthesia recovery stay.
Makaela E. DeLucca.
DUNE: DigitalUNE Spring 2023