Rachianesthésie chez l'enfant : faut-il encore l'utiliser ?

Spinal anesthesia was considered as the gold standard for inguinal hernia repair in the awaked premature newborn. The technique is claimed to decrease the risk of postoperative apnea. However, its benefit compared to a regional anesthetic technique associated with the inhalation of sevoflurane is a matter of controversy in the literature. In older children, the indications include short distal surgery and spinal morphine analgesia after major surgery. Despite technical facility and the low incidence of side effects, spinal anesthesia is eventually uncommonly used in paediatrics. In the same time, an extensive literature focusing on the neurotoxicity of general anesthetics on the developing brain alerts about the potential risks associated with exposure of newborns to a general anesthesia. The objective of this paper is to discuss the arguments likely to lead to spinal anesthesia rehabilitation.