Thoracic Segmental Spinal Anesthesia for Laparoscopic Surgeries in Pediatric Patients: A Retrospective Case Series

Thoracic segmental spinal anesthesia (TSSA) is a developing regional anesthesia approach that involves administering local anesthetics into the thoracic spine to produce a targeted nerve block. This segmental block provides stable hemodynamics and early recovery. Lumbar spinal anesthesia is a common practice in children, and TSSA can be a promising technique due to its advantages. Despite the theoretical advantages of TSSA in pediatric patients, there is a paucity of literature describing its clinical use, safety profile, and outcomes in this population. This case series presents our initial clinical experience with TSSA in pediatric patients undergoing various laparoscopic surgical procedures. We aim to highlight the feasibility and safety of TSSA in the pediatric population while contributing to filling the gap in the literature supporting its broader application. Five pediatric patients undergoing various surgeries under TSSA were included in this study conducted between July 2021 and April 2022 at a single center. Demographic, clinical, TSSA technique, intraoperative, and postoperative data were extracted from hospital records. There were three male and two female patients between the ages of 6 and 13 years. One patient had sickle cell anemia, and one was suffering from an upper respiratory tract infection. All cases were conducted successfully under TSSA without significant complications. This study demonstrates that TSSA can be a feasible and safe regional anesthetic technique in pediatric patients undergoing surgeries confined to thoracic and upper abdominal dermatomes. While our findings are encouraging, larger prospective studies are necessary to establish standardized protocols, optimize dosing strategies, and further validate the role of TSSA in pediatric anesthesia practice.