Society for Pediatric Pain Medicine
Better Care for Children in Pain

Spinal anesthesia in infants is a viable anesthesia technique for surgeries such as inguinal hernia. A 2 month-old former 30 week gestation female is scheduled for a unilateral inguinal hernia repair. The resident on the case has a strong desire to perform the spinal. How does practitioner level (Attending/CRNA/Resident) matter in terms of success/failure of placement of an infant spinal?

According to a study by Ivani and colleagues, the optimum concentration of levobupivacaine at 1 ml/kg in a single shot caudal without any additive was 0.2%. What advantage did the 0.2% concentration have over the 0.25% concentration? Was there any impact on analgesia duration?

A 4-year old male with Wilm's tumor is having exploratory laparotomy. He also has a history of severe scoliosis and epidural placement failed. The surgery team requests a "Tap Block". The anesthesia team decides to place a quadratus lumborum block. Which injection site on ultrasound would have a higher chance of paravertebral spread?