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• W2069965720 abstract "Sir—We read the excellent review article in the special issue of ‘Pediatric Regional Anesthesia’, Spinal blocks, by Hannu Kokki (1) with great interest. We have been using spinal anesthesia in pediatric patients for the last decade, and we have recently published our results regarding the pediatric spinal anesthesia (2). Besides, we also widely used pediatric regional anesthesia techniques in our clinic whenever possible (2–6). We want to draw attention to two points about the review article by Hannu Kokki (1). Firstly, in the section ‘Indications for spinal anesthesia’, the author mentioned that spinal anesthesia might be useful for children with neuromuscular or pulmonary disease. However, author referenced those two adolescents had progressive spinal scoliosis with poor pulmonary function; one of them is 14 years old with Hurler–Scheie syndrome, and the other one is 17 years old with Duchenne muscular dystrophy (DMD) in 1991 (7). We are surprized that our report is the first case published in ‘Pediatric Anesthesia– 2007’ on spinal anesthesia for 8-year-old myasthenic children was not cited (3). In addition to this, we previously reported in ‘Pediatric Anesthesia– 2009’ about spinal anesthesia for 3-year-old children with DMD was not cited (4). Anesthetic concerns for patients with neuromuscular disease such as MG and DMD focus on avoiding muscle relaxants and close monitoring of perioperative respiratory function (with both pulse oximetry and capnography) to detect any early respiratory impairment. The use of regional or local anesthesia with or without proper sedation seems warranted whenever possible in children and adult. For this reason, we think that the spinal anesthesia is a safer and should be the first choice of anesthesia method when appropriate for pediatric patients with pulmonary disease or neuromuscular disease such as MG and DMD. Secondly, in the section ‘Sedation’, the author mentioned about the advantage of dexmedetomidine sedation during pediatric regional anesthesia and said that further studies are needed in this area. However, we have already reported this in ‘Pediatric Anesthesia– 2008’ on dexmedetomidine sedation for pediatric regional anesthesia in three high-risk infants that was not cited (5). We think that the sedation by intravenous ketamine 1 mg·kg−1 followed by bolus dexmedetomidine 1 μg·kg−1·10 min−1 and immediately start infusion of dexmedetomidine 0.7–1 μg·kg−1·h−1 provided excellent sedative conditions during pediatric regional anesthesia. I would like to present my special thanks to the Pediatric Anesthesia for the special issue of pediatric regional anesthesia. No conflicts of interest declared." @default.
• W2069965720 created "2016-06-24" @default.
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• W2069965720 date "2012-05-17" @default.
• W2069965720 modified "2023-10-05" @default.
• W2069965720 title "Spinal anesthesia is a valid alternative to other anesthetic approaches for children with neuromuscular disease, and dexmedetomidine sedation is a safe method for pediatric regional anesthesia" @default.
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• W2069965720 doi "https://doi.org/10.1111/j.1460-9592.2012.03869.x" @default.
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