Sedation protocols for Ponseti clubfoot Achilles tenotomy

Abstract Purpose Ponseti clubfoot management requires percutaneous tenotomy in 90% of cases, typically with local anesthesia. We report two light sedation protocols for outpatient tenotomy. Methods Operating room protocol: 24 patients (36 club feet; mean age at tenotomy, 70 days) underwent mask indu...

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Bibliographic Details
Published in:Journal of children's orthopaedics 2007-12, Vol.1 (6), p.333-335
Main Authors: Bor, Noam, Katz, Yeshayahu, Vofsi, Oded, Herzenberg, John E., Zuckerberg, Aaron L.
Format: Article
Language:English
Subjects:
Analgesics
Anesthesiology
Babies
Breastfeeding & lactation
Feet
Foot diseases
General anesthesia
Intensive care
Intubation
Local anesthesia
Morbidity
Nitrous oxide
Original Clinical
Orthopedics
Pain
Patients
Pediatrics
Surgery
Tendons
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Summary:Abstract Purpose Ponseti clubfoot management requires percutaneous tenotomy in 90% of cases, typically with local anesthesia. We report two light sedation protocols for outpatient tenotomy. Methods Operating room protocol: 24 patients (36 club feet; mean age at tenotomy, 70 days) underwent mask induction with oxygen/nitrous oxide. Pediatric intensive care unit protocol: five patients (eight club feet; mean age at tenotomy, 119 days) underwent intravenous propofol infusion with supplemental oxygen. Results All patients were discharged several hours after surgery with no complications. Anesthesia that is administered intravenously might have less risk of bronchial reaction than anesthesia that is administered by inhalation. Conclusions Our light sedation protocols offer safe alternatives to general anesthesia. Disadvantages include increased cost when compared with local anesthesia. Light sedation can be used effectively and has advantages when treating older infants who might struggle while under local anesthesia.
ISSN:1863-2521
1863-2548
DOI:10.1007/s11832-007-0059-8