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Sedation during spinal anaesthesia in infants
H Hermanns1, M F Stevens, R Werdehausen
1Department of Anaesthesiology, University Hospital Düsseldorf Germany.
British Journal of Anaesthesia
|July 4, 2006
Summary
Spinal anaesthesia causes significant sedation in infants, similar to adults. This sedative effect of spinal anaesthesia in infants should be considered when administering additional sedatives.
Area of Science:
- Pediatric Anesthesiology
- Neuroscience
- Pharmacology
Background:
- Neuraxial anesthesia reduces sedative and anesthetic requirements in adults.
- Spinal anesthesia alone exhibits sedative properties, potentially due to reduced afferent stimulation of the reticular activating system.
- The study investigated if this sedative mechanism is active in infants.
Purpose of the Study:
- To evaluate the sedative effects of spinal anesthesia in infants.
- To determine if the sedative mechanism observed in adults is also present in infants undergoing spinal anesthesia.
Main Methods:
- Twenty former preterm infants received spinal anesthesia with hyperbaric bupivacaine and epinephrine without additional sedatives.
- Sedation levels were monitored using the bispectral index (BIS) and 95% spectral edge frequency (SEF(95)).
- Hemodynamic parameters, including mean arterial pressure and heart rate, were recorded.
Main Results:
- Bispectral index (BIS) scores significantly decreased from baseline after spinal anesthesia, reaching lowest values at 30 minutes.
- 95% spectral edge frequency (SEF(95)) also showed a significant decline, indicating increased sedation.
- Mean arterial pressure decreased significantly, while heart rate remained stable.
Conclusions:
- Infants exhibit pronounced sedation following spinal anesthesia, comparable to adults.
- The sedative effects of spinal anesthesia in infants, particularly former preterm infants, must be considered when administering other sedatives.
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