Study of spinal anaesthesia in children at rural healthcare set up

The aim of present study is to report our experience concerning the effectiveness, quality of analgesia, ease of performance, complications and safety of spinal anaesthesia in children undergoing infra-umbilical surgery. An open, non-comparative study was performed on 40 children aged 5-15 years undergoing elective infra-umbilical surgery. After parents' written consent and premedication, spinal anaesthesia was induced with hyperbaric bupivacaine (5mg/ml), 0.4mg/kg for children up to 15 kg body weight and 0.3mg/kg for >15 kg via L3-L4 or L4-L5 interspace in lateral decubitus position. A 26-gauge disposable hypodermic needle with attached syringe and drug appearing at the tip of needle was used for lumbar puncture. The success rate, spread and duration of analgesia, degree-of motor block, additional anaesthetic, haemodynamic parameters and adverse effects were recorded. The descriptive results were presented as mean (SD) or number (%). Value of p<0.05 was considered significant. The success rate of the procedure was 92.5%. The mean onset of analgesia was 4.2(1.8) minutes. The highest sensory level (T8) was achieved within 6.2(3.1) minutes. The duration of block was 69.8(15) minutes. The dose of intrathecal bupivacaine used was 4-9 mg. No evidence of cardiovascular instability, postdural puncture headache, transient neurological symptoms, urinary complication was observed. Spinal anaesthesia with hyperbaric bupivacaine using 26-gauge hypodermic needle provides safe and effective analgesia for paediatric infra-umbilical surgery with high success rate.