Anaesthesia for Paediatric Urology
Highlights
- A deep plane of anaesthesia and adequate analgesia is important before insertion of the cystoscope as urethral stimulation may precipitate laryngospasm. (View Highlight)
- In conditions with a high incidence of associated spinal abnormalities, for example, cloacal exstrophy, imaging should be undertaken before considering central neuraxial block for analgesia. (View Highlight)
- Laparoscopic procedures produce intense surgical stimulation until almost the end of surgery. (View Highlight)
- Hypospadias is a relatively common congenital defect with an incidence of 1:350 male births.[1](javascript:;) The urinary meatus is on the undersurface of the penis (ventral) and there may be an associated downward curvature of the penis, called chordee. Surgical correction is performed at 6–18 months of age (View Highlight)
- Severe hypospadias with unilateral or bilateral impalpable testes or ambiguous genitalia requires genetic and endocrine investigations to exclude congenital adrenal hyperplasia (View Highlight)
- General anaesthesia (GA) is frequently combined with a regional anaesthetic technique for hypospadias correction (View Highlight)
- For hypospadias repair, caudal extradural block is effective and reduces the requirement for postoperative supplementary opioid administration (View Highlight)
- Penile nerve block may be suitable only if the hypospadias is distal and is associated with a lower incidence of urinary retention compared with a caudal block (View Highlight)
- Latex, a natural rubber, is the sap of the tree, Hevea brasiliensis, and is used in the manufacture of rubber gloves and other medical products. Sensitization may occur due to early and prolonged exposure to products containing latex (View Highlight)
- Children undergoing repeated surgery, particularly in the first year of life, are at greater risk of developing latex allergy (View Highlight)
- Caudal block is useful for analgesia after infraumbilical operations (T10). (View Highlight)