Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-28T04:14:17.583Z Has data issue: false hasContentIssue false
  • English
  • Français

Spinal anaesthesia in full-term infants of 0–6 months: are there any differences regarding age?

Published online by Cambridge University Press:  13 April 2005

A. Köroğlu ,
M. Durmuş ,
T. Toğal ,
Z. Özpolat  and
M. Ö. Ersoy
A. Köroğlu
Affiliation:
Inonu University, Faculty of Medicine, Department of Anaesthesiology, Malatya, Turkey
M. Durmuş
Affiliation:
Inonu University, Faculty of Medicine, Department of Anaesthesiology, Malatya, Turkey
T. Toğal
Affiliation:
Inonu University, Faculty of Medicine, Department of Anaesthesiology, Malatya, Turkey
Z. Özpolat
Affiliation:
Inonu University, Faculty of Medicine, Department of Anaesthesiology, Malatya, Turkey
M. Ö. Ersoy
Affiliation:
Inonu University, Faculty of Medicine, Department of Anaesthesiology, Malatya, Turkey
Get access

Abstract

Summary

Background and objective: The aim of the study was to report our experience concerning the effectiveness, complications and safety of spinal anaesthesia, and to determine whether spinal anaesthesia was effective in full-term infants undergoing elective inguinal hernia repair.

Methods: Sixty-eight full-term infants aged <6 months were included in the study. Infants were divided into three groups; Group I (<1 month, n = 20), Group II (>1 and <3 months, n = 26), and Group III (3–6 months, n = 22). All spinal blocks were performed under mask inhalation anaesthesia. A dose of bupivacaine 0.5% 0.5 mg kg−1 was used for infants under 5 kg and 0.4 mg kg−1 for those over 5 kg. Heart rate, mean arterial pressure, respiratory rate and SPO2 were recorded before and after spinal anaesthesia at 5 min intervals. Time to onset of analgesia, time to start of operation, duration of operation, anaesthesia and hospitalization, postoperative analgesic requirement and complications were recorded.

Results: Adequate spinal anaesthesia without sedation was better, time to obtain maximum cutaneous analgesia was shorter and need for sedation and postoperative analgesic requirement were significantly lower in Group I. Although heart rate, mean arterial pressure and respiratory rate decreased <20% in all groups following spinal analgesia, the decrease in Group I was lower than the others.

Conclusions: Spinal anaesthesia is an effective choice in inguinal hernia repair for full-term infants aged <1 month, providing excellent and reliable surgical conditions. However, this technique is not as useful for infants aged between 1 and 6 months.

Keywords

ANAESTHESIA, spinalANAESTHETICS, LOCAL, bupivacaineAGE GROUPS, infantsSURGICAL PROCEDURES, OPERATIVE, inguinal hernia repair
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 2 , February 2005 , pp. 111 - 116
Copyright
2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Tobias JD. New insights into regional anaesthesia in children: new techniques and new indications. Curr Opin Anaesthesiol 2001; 14: 345–352.Google Scholar
Vane DW, Abajian JC, Hong AR. Spinal anaesthesia for primary repair of gastroschisis: a new and safe technique for selected patients. J Pediatr Surg 1994; 29: 1234–1235.Google Scholar
Giaufre E, Dalens B, Gombert A. Epidemiology and morbidity of regional anaesthesia in children: a one-year prospective survey of the French-Language Society of Paediatric Anaesthesiologists. Anesth Analg 1996; 83: 904–912.Google Scholar
Polaner DM, Suresh S, Cote CJ. Pediatric regional anaesthesia. In: Cote CJ, Todres ID, Ryan JF, Goudsouzian NG, eds. A Practice of Anaesthesia for Infants and Children. Philadelphia, USA: WB Saunders Inc, 2001: 636–674.
Anders TF, Chalemian RJ. The effects of circumcision on sleep–wake states in human neonates. Psychosom Med 1974; 36: 174–179.Google Scholar
Cook B, Grubb DJ, Aldridge LA, et al. Comparison of the effects of adrenaline, clonidine and ketamine on the duration of caudal analgesia produced by bupivacaine in children. Br J Anaesth 1995; 75: 698–701.Google Scholar
Webster AC, McKishnie JD, Kenyon CF, et al. Spinal anaesthesia for inguinal hernia repair in high-risk neonates. Can J Anaesth 1991; 38: 281–286.Google Scholar
Williams JM, Stoddart PA, Williams SAR. Post-operative recovery after inguinal herniotomy in ex-premature infants: comparison between sevoflurane and spinal anaesthesia. Br J Anaesth 2001; 86: 366–371.Google Scholar
Webster AC. Lumbar epidural anesthesia for inguinal hernia repair in low birth weight infant. Can J Anaesth 1993; 40: 670–675.Google Scholar
Veyckemans F, Obberg VLJ, Gouverneur JM. Lessons from 1100 pediatric caudal blocks in a teaching hospital. Reg Anesth 1992; 17: 119–125.Google Scholar
Sukhani R. Calculating local anesthetic dose for infant spinal: body weight versus spinal length. Anesth Analg 1993; 76: 917–918.Google Scholar
Rice LJ, DeMars PD, Whalen TV, et al. Duration of spinal anaesthesia in infants less than one year of age. Reg Anesth 1994; 19: 325–329.Google Scholar
Parkinson SK, Little WL, Malley RA, et al. Use of hyperbaric bupivacaine with epinephrine for spinal anaesthesia in infants. Reg Anesth 1990; 15: 86–88.Google Scholar
Dalens BJ. Regional anaesthetic techniques. In: Bissonnette B, Dalens B, eds. Pediatric Anaesthesia Principles and Practice. New York, USA: McGraw-Hill Inc, 2002: 528–575.
Wright TE, Orr RJ, Haberkern CM, Walbergh EJ. Complications during spinal anaesthesia in infants: high spinal blockade. Anesthesiology 1990; 73: 1290–1292.Google Scholar
Sartorelli KH, Abajian JC, Kreutz JM, et al. Improved outcome utilizing spinal anaesthesia in high-risk infants. J Pediatr Surg 1992; 27: 1022–1025.Google Scholar
Harnik EV, Hoy GR, Potolicchio S, et al. Spinal anaesthesia in premature infants recovering from respiratory distress syndrome. Anesthesiology 1986; 64: 95–99.Google Scholar
Frumiento C, Abajian JC, Vane DW. Spinal anaesthesia for preterm infants undergoing inguinal hernia repair. Arch Surg 2000; 135: 445–451.Google Scholar
Oberlander TF, Berde CB, Lam KH, et al. Infants tolerate spinal anaesthesia with minimal overall autonomic changes: analysis of heart rate variability in former premature infants undergoing hernia repair. Anesth Analg 1995; 80: 20–27.Google Scholar
Gingrich BK. Spinal anaesthesia for a former premature infant undergoing upper abdominal surgery. Anesthesiology 1993; 79: 189–190.Google Scholar
Easley RB, George R, Connors D, Tobias JD. Aseptic meningitis after spinal anaesthesia in an infant. Anesthesiology 1999; 91: 305–307.Google Scholar