Exploratory Laporotomy in a Neonate Under Spinal Anaesthesia

Exploratory Laparotomy is a surgical incision utilised in both emergency and elective scenarios to gain access to abdominal surgery. General anaesthesia is usually necessitated due to the substantial insult of the approach and to facilitate organ relaxation and paralysis. However, this brings with it the need for an assessment of the suitability of the anaesthetic technique, with a large number of patients having comorbidities significant enough to exclude them from surgery. Locoregional anaesthesia, provided via spinal, epidural, or a combined approach offers a means of providing anaesthesia that places a reduced level of strain on patients’ cardiorespiratory function. We review the existing literature on the topic of so-called “awake laparotomy” performed with locoregional anaesthesia and present a case series including both elective and emergency procedure. The first regional anesthetic technique performed was spinal anesthesia, and the first operation under spinal anesthesia was in 1898 in Germany by August Bier. Before this, the only local anesthetic techniques were topical anesthesia of the eye and infiltration anesthesia. The central nervous system (CNS) comprises the brain and spinal cord. Neuraxial anesthesia refers to the placement of local anesthetic in or around the CNS. Spinal anesthesia is a neuraxial technique in which local anesthetic is placed directly in the intrathecal (subarachnoid) space. This activity reviews the technique, contraindications, and indications of spinal anesthesia and highlights the interprofessional team’s role in managing these patients.