N. Vanaja Lakshmi
BACKGROUND Even after a vast safety record, the role of spinal anaesthesia (SA) as a primary anaesthetic technique in children remains contentious and is mainly limited to specialized paediatric centers. The aim of the study was to evaluate the success rate, complications and hemodynamic stability related to paediatric spinal anaesthesia. MATERIALS AND METHODS 60 paediatric patients aged 6 months to 5 years posted for elective below umbilical general surgery were included in study. Spinal anaesthesia was received with Bupivacaine 0.5%, 0.4 mg/kg body weight. These patients were kept immobile with inhalational anaesthesia using Sevoflurane. Demographic data, vital parameters, supplemental sedation, number of attempts for lumbar puncture, sensory-motor block characteristics, and complications were noted. RESULTS There was no significant change in the mean value of systolic blood pressure, diastolic blood pressure, respiratory rate, and oxygen saturation after subarachnoid block at all time periods in study. Pulse rate showed a significant increase (12%) after 5 min of subarachnoid block as compared with baseline. After 10 min of block 58 (97%) patients achieved desired peak sensory level of T10 and Bromage score of 3. In successful spinal cases, mean peak sensory level after 10 min of block was T 6.23 ± 1.21 (T4-T8) and the median was T6. Mean sensory level at the end of surgery was T 8.22 ± 1.39 (T6-T10) and the median was T8. In all successful blocks the modified Bromage score was 3, which was seen in 58 (97%) patients. Mean time to two segment regression was 43.91 ± 9.9(30-70) min. Mean time to return Bromage to 0 was 112.31 ± 21.11 (70-160) min. Sensory and motor block recovery was complete in all the patients. Shivering was seen only in 2 (3%) patients intraoperatively. No other complication was noted. CONCLUSION Paediatric spinal anaesthesia is a safe and effective anaesthetic technique for lower abdominal and lower limb surgeries of shorter duration (<90 min) with high success rate.
