Spinal anesthesia for spine and lower extremity surgery in infants.

More premature infants are now surviving because of advances in perinatal care. Premature infants often have congenital anomalies requiring operative correction and are at increased risk for developing postoperative apnea. The purpose of this study was to review our results with spinal anesthesia in infants. Twenty-two infants (average age at operation, 11 weeks) had spinal anesthesia for surgery to the spine or lower extremities. One patient with bilateral developmental dysplasia of the hip had staged operations 1 month apart. Twelve infants (55%) were considered to be at increased risk for general anesthesia. The spinal anesthetic was 1% tetracaine made hyperbaric with 10% dextrose (tetracaine dose, 0.5 mg/kg). Spinal anesthesia was successful in all 23 cases. The average follow-up was 4 years, 1 month, and no complications were attributed to the spinal. Spinal anesthesia is a safe and effective substitute for general anesthesia in infants having spinal and lower extremity operations and is particularly beneficial for high-risk infants.