title: Feasibility of laparoscopic pyloromyotomy under spinal anesthesia.
abstract: BACKGROUND
  Most agents used for GA are considered to be neurotoxins and affect developing brains in experimental models, leading to a push for spinal anesthesia (SA). There are no reports of laparoscopic pyloromyotomy (LP) performed under SA. We present our experience with LP and SA and discuss feasibility.
  
  
  METHODS
  A retrospective analysis was performed on a consecutive series of patients who underwent an LP. An 'intent to treat' analysis was utilized, and GA was compared to SA. Data regarding patient characteristics, operative intervention, complications, and postoperative course were collected.
  
  
  RESULTS
  Twelve cases had attempted SA for the LP, 9 were successful. During the same time, 12 cases underwent LP under GA. We found no difference for length of procedure, time to the first feed, or the postoperative LOS. The time to leave the OR after conclusion of the procedure was significantly shorter for the SA group (14min vs. 28min, p<0.001). There were no complications from the SA, however three cases had to be converted to GA.
  
  
  CONCLUSIONS
  It is feasible and safe to perform laparoscopic pyloromyotomy under spinal anesthesia. Given the increasing concern over the use of GA in infants, consideration may be given to use of SA for LP.
authors.affiliation: Department of Surgery, Division of Pediatric Surgery. Electronic address: saleem.islam@surgery.ufl.edu.
authors.forename: Saleem
authors.initials: S
authors.lastname: Islam
authors.affiliation: Department of Surgery, Division of Pediatric Surgery.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: Larson
authors.affiliation: Department of Surgery, Division of Pediatric Surgery.
authors.forename: David W
authors.initials: DW
authors.lastname: Kays
authors.affiliation: Department of Anesthesia, University of Florida College of Medicine, Gainesville, FL.
authors.forename: Maria D
authors.initials: MD
authors.lastname: Irwin
authors.affiliation: Department of Anesthesia, University of Florida College of Medicine, Gainesville, FL.
authors.forename: Norman
authors.initials: N
authors.lastname: Carvallho
mesh_terms: D000768:Anesthesia, General; D000775:Anesthesia, Spinal; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D011707:Pyloric Stenosis / Q000601:surgery*; D011708:Pylorus / Q000601:surgery; D012189:Retrospective Studies
keywords: Infant; Laparoscopy; Pyloromyotomy; Spinal anesthesia