ESPU Congress 2018 - Abstract Book

101 11–14 APRIL, 2018, HELSINKI, FINLAND 16:37–16:42 S12-2 (LO) ★ SPINAL ANESTHESIA IN THE YOUNGEST OF PATIENTS: NO NEED FOR ADVANCED AIRWAY MANAGEMENT AND REDUCED NARCOTIC USAGE Kristin EBERT  1 , Emmett WHITAKER  2 and Venkata JAYANTHI  1 1) Nationwide Children's Hospital, Section of Urology, Columbus, USA - 2) Nationwide Children's Hospital, Anesthesia, Columbus, USA PURPOSE Concerns regarding potential negative effects of inhalataional and intravenous anesthetics on neurocognitive development has led to a growing interest in alternative forms in infants. We report on our institution’s outcomes with the use of spinal anesthesia (SA) for urological surgery in infants less than 90 days of age, and compare their outcomes with a matched cohort of patients who underwent general anesthesia (GA). MATERIAL AND METHODS Patients less than 90 days of age who underwent SA for four procedures (inguinal hernia repair, scrotal exploration for torsion, PUV ablation, ureterocele puncture) were identified from our SA database. An age- and procedure-matched control cohort was identified from a list of patients who underwent the same procedures under GA. Outcomes recorded included success rate of spinal, complications, narcotic and supplemental medication usage, airway management, need for sup- plemental oxygen, and length of hospital stay. RESULTS Forty patients were identified; 20 in the SA group and 20 in the GA group. The mean age of the entire cohort was 45.3 days. Eighty percent (16/20) of SA patients had successful SA without conversion to GA; reasons for conversion included 3 with a failed lumbar puncture and 1 with refractory agitation. All GA patients had endotracheal intubation, whereas none of the successful SA patients needed any airway management. SA patients were significantly less likely to receive narcotics during the operative procedure compared to the GA group (p=0.001), and also had a sig- nificantly lower mean morphine equivalent dose/kilogram (p=0.002). Patients in the SA group were also significantly less likely to receive any supplemental medications during the operative procedure (p=0.001), particularly intravenous corticosteroids (p<0.001). There were no significant differences in length of hospitalization between groups. CONCLUSIONS The use of SA in babies obviates the need for endotracheal tube placement and airway manage- ment, and avoids the theoretic concerns regarding the effects of GAon neurocognitive development.