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Evaluation of Spinal Anaesthesia in Paediatric Patient undergoing Lower Abdominal and Lower Limb Surgeries

Ravikumar M. Parmar, Assistant Professor, Department of Anaesthesiology, Government Medical College and Sir Takhtsinhji, General Hospital, Bhavnagar. Gujarat 364001, India. , Shobhana C. Gupta1 , Ravikumar M. Parmar2

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Indian Journal of Anesthesia and Analgesia 5(3):p 409-414, March 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.9

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Abstract

Purpose: Spinal anaesthesia is a useful technique for infraumbilical and lower limb surgeries. The misconceptions regarding its overall safety, feasibility and reliability can be better known with greater use, its applications and research. We have designed this study to analyze the success rate, complications, and hemodynamic stability related to spinal anaesthesia in paediatric patients aged 5 years to 12 years. Methods: Total 60 patients were included in this study. Spinal anaesthesia was given with injection hyperbaric bupivacaine (0.5%) in a dose of 0.3 mg/kg. Demographic data, vital parameters, number of attempts for lumbar puncture, sensory-motor block characteristics and complications were noted. Results: Lumbar puncture was successful in 1st attempt in 46 (76.66%) patients and 2nd attempt was required in 14 (23.34%) patients. Vital parameters were not altered. Mean peak sensory level achieved was T7.1 ± 1.67 (T4-12) and mean time for two segment regression was 45.33±4.71 minutes. Modified Bromage score was 3 in all patients. Sensory and motor block recovery was complete in all patients. Mean duration of surgery was 77.2 ± 11.88 minutes. The incidence of complications was minimal with hypotension and bradycardia. Conclusion: Our study concludes that spinal anaesthesia in paediatric patients is feasible owing to its safety, higher success rate, and very low complications. Due to its early motor recovery, batter postoperative analgesia with minimal physiological alteration, no risk of respiratory depression and pulmonary aspiration, it reduces overall morbidity and mortality. Hence it is a preferred technique for daycare lower abdominal and lower limb surgeries.

 

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.9

Keywords

Spinal Anaesthesia; Lower Limb Surgery; Lower Abdominal Surgery; Pediatric Spinal Anaesthesia; Bupivacaine. 

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