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Spinal anesthesia in children: no longer an anathema!
Ambrose Rukewe1, Temitope Alonge, Akinola Fatiregun
1Department of Anesthesiology, University College Hospital, Ibadan, Nigeria. ambyrukewe@gmail.com
Paediatric Anaesthesia
|October 23, 2010
Summary
Spinal anesthesia is a safe and effective option for pediatric lower extremity surgeries in Nigeria, showing minimal hemodynamic impact. This study highlights its underutilization and advocates for its increased use in children.
Area of Science:
- Pediatric Anesthesiology
- Regional Anesthesia
- Surgical Safety
Background:
- Spinal anesthesia is underutilized in Nigerian pediatric surgery, with caudal and general anesthesia being the primary methods.
- Previous perceptions considered spinal anesthesia unsuitable for children in this region.
Purpose of the Study:
- To evaluate cardiovascular changes associated with spinal anesthesia in children.
- To assess the duration of spinal block, surgery length, and spinal needle length for lumbar puncture.
- To determine the incidence of complications related to pediatric spinal anesthesia.
Main Methods:
- A study involving 32 pediatric patients (ages 2-12, ASA 1-2) undergoing orthopedic and plastic surgery.
- Spinal blocks were administered at the L5/S1 interspace using 0.5 mg·kg(-1) bupivacaine.
- Cardiovascular parameters, block characteristics, and complications were monitored.
Main Results:
- Satisfactory anesthesia was achieved in 31 out of 32 children.
- No instances of oxygen desaturation, bradycardia, or hypotension were observed.
- Minor complications included mild headaches (6.5%), nausea/vomiting (9.7%), and postspinal shivering (16.1%).
- A positive correlation was found between patient size and spinal needle length (r = 0.7, P = 0.0001).
Conclusions:
- Pediatric spinal anesthesia demonstrates minimal hemodynamic disruption, establishing it as a safe technique for lower extremity surgeries.
- The study supports spinal anesthesia as a safe and effective alternative for pediatric patients in Nigeria.
- This technique, previously unpopular, proves to be viable and effective in the pediatric population.
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