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Case Report
Limb amputation of an infant with transposition of great arteries using spinal anesthesia
1 Anesthesiologist, Surgical Emergency Hospital, Surgical Teaching Hospital Maternity Teaching Hospital Kurdistan Region Iraq
2 ESA member, Anesthesiologist Surgical Emergency Hospital and Surgical Teaching Hospital Kurdistan Region Iraq
3 Surgical Emergency Hospital and Shahid Doctor Aso Neurosurgical and Ophthalmological Hospital, Kurdistan Region Iraq
4 Shorsh Dental Teaching Hospital Kurdistan Region Iraq
Address correspondence to:
Blind G. Al-Talabani
DIS. 38, St. 107, H.N 21, Kurdistan Region
Iraq
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Article ID: 100016A05BA2018
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How to cite this article
Al-Talabani BG, Kareem TM, Hasan SO, Rasheed JJ. Limb amputation of an infant with transposition of great arteries using spinal anesthesia. Edorium J Anesth 2018;4:100016A05BA2018.ABSTRACT
Introduction: Spinal and caudal anesthesia are useful anesthetic techniques for infants compared to general anesthesia. In case of infants lumbar puncture can be safely performed at or just below the intercristal line. Due to the presence of loose fatty tissues in the caudal extradural space, it becomes safe and easy to insert a cannula enabling easy cranial spread of local anesthetic drugs. Increased production and absorption of cerebrospinal fluid in infants lead to administration of higher doses of local anesthetics. However, this spinal and caudal anesthesia has lesser risk of post-operative apnea in infants compared to general anesthesia.
Case Report: A three-month-old male infant, whose body weight was seven and half kilograms, was afflicted with ischemia which extended to half of his right leg. There was gangrene on his right big toe as well. These developments occurred after cardiac catheterization was implemented through right femoral vein cannulation. Due to high-risk of transposition of great arteries in general anesthesia, the surgeons finalized under spinal anesthesia in order to bypass the infected respiratory system, prevent aspiration because of full stomach, and to get better postoperative analgesia.
Conclusion: Spinal anesthesia is an alternative option to general anesthesia in high risk patients owing to its safety. However, in case of spinal complications or failure of spinal anesthesia, the anesthetist should always get ready with the high risk general anesthesia.
Keywords: Amputation, Bupivacaine, Infant, Spinal anesthesia, Transposition of great arteries
SUPPORTING INFORMATION
Author Contributions
Blind G. Al-Talabani - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Twana Kareem - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Seerwan Hasan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Jwan Rasheed - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2018 Blind G. Al-Talabani et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
