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Hemodynamic changes during spinal anesthesia in premature infants with congenital heart disease undergoing inguinal hernia correction.
MedLine Citation:
PMID:  22587774     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction:  There are conflicting reports on the effects of spinal anesthesia (SA) on hemodynamics. Data on the hemodynamic effects of SA in infants with congenital heart disease (CHD) are limited. Methods:  We reviewed our experience with 44 unsupplemented SA with 1 mg·kg(-1) of either hyperbaric tetracaine or bupivacaine in premature and former premature infants with noncyanotic CHD. Hemodynamics and oxyhemoglobin saturation (SpO(2) ) were assessed. Neither preoperative fluid boluses nor atropine was administered to any of the infants. Results:  There was no significant change in systolic, diastolic, or mean blood pressures from pre-SA induction compared with end of surgery. Heart rate showed a small but systematic decline (mean change of 10 beats per minute, P < 0.01) but was within the normative range values for age. There was a small, but clinically insignificant increase in SpO(2) across the time course. Intraoperatively, two infants developed transient apneic spells. No infant developed postoperative apnea, oxygen desaturation, or bradycardia. Conclusions:  The data suggest that SA with 1 mg·kg(-1) of either hyperbaric tetracaine or bupivacaine can be used safely as the sole anesthetic for inguinal hernia repair in infants with noncyanotic CHD even when fluid restricted and apparently causes minimal respiratory complications in these infants.
Authors:
Ze'ev Shenkman; Victor M Johnson; David Zurakowski; Shmuel Arnon; Navil F Sethna
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-15
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  -     ISSN:  1460-9592     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
 Department of Anesthesia, Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel  Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, and Harvard Medical School, Boston, MA, USA  Department of Neonatology, Meir Medical Center, Kfar Saba and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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