Spinal anesthesia after intraoperative cardiac arrest during general anesthesia in an infant

Whitaker, Emmett E; Miler, Veronica; Bryant, Jason; Proicou, Stephanie; Jayanthi, Rama; Tobias, Joseph D

With a well-trained, multidisciplinary team of pediatric anesthesiologists, surgeons, and nursing staff, the use of spinal anesthesia in these high-risk patients and the general population will be met with high patient safety outcomes and parent satisfaction. Given our center's extensive experience with spinal anesthesia, we are comfortable and facile with the placement of an intravenous cannula in an anesthetized foot or leg after the placement and onset of spinal anesthesia. The safety of this practice is supported by the limited or absent incidence of hemodynamic changes related to spinal anesthesia in infants. This practice is the same as that followed by the only other center in the US with a large spinal anesthesia program (Dr R Williams, The University of Vermont, personal communication, September, 2015). The authors would not suggest or condone such a practice in the absence of significant experience with spinal anesthesia in neonates and infants.