We experienced spinal anesthesia for inguinal hernia repair in combination with general anesthesia in a 4-year-old child with functional laryngeal stenosis and tendency of laryngeal edema. His airway was managed without endotracheal tube or laryngeal mask airway because these devices could worsen the upper airway stenosis. Spinal anesthesia offered reliable and potent analgesia leading to safe anesthetic management under spontaneous breathing. Although spinal anesthesia in combination with general anesthesia is not common in pediatric patients, it is effective and safe to apply for a case requiring more reliable and potent analgesia with understanding anatomical and physiological characteristics in children.
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