Document Detail

Spinal anesthesia in 62 premature, former-premature or young infants--technical aspects and pitfalls.
MedLine Citation:
PMID:  11861344     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To highlight technical aspects and pitfalls of spinal anesthesia (SA) in infants. METHODS: The medical history and perioperative course of all infants who underwent SA over a 28-month period were collected (retrospectively in the first 20). RESULTS: Sixty-two infants underwent surgery under SA. Fifty-five were premature and former-premature, postconceptional age 43.3 +/- 5.0 weeks, weight 3261 +/- 1243 g. Of these, 21 had co-existing disease: cerebral (six), cardiac (nine), pulmonary (11) and urological (six). Hyperbaric tetracaine or bupivacaine 1 mg x kg(-1) with adrenaline was administered. Four infants (three premature) required N(2)O supplementation and three needed general anesthesia. The supplementation rate was similar or lower than in previous studies. Postoperatively, all seven were shown to have lower limb motor and sensory blockade. Complications in premature patients included intraoperative hypoxemia (two), apnea (two) and bradycardia (one). Postoperative complications included bradycardia (three), hypoxemia (one) and apnea and hypoxemia (one). The postoperative complication rate was similar to previous studies. CONCLUSION: Successful SA in infants depends on close attention to preoperative assessment, appropriate patient positioning during and after lumbar puncture, drug dosing and intra- and postoperative cardiorespiratory monitoring. A relatively high dose of hyperbaric solution of tetracaine or bupivacaine with adrenaline should be administered.
Ze'ev Shenkman; David Hoppenstein; Ita Litmanowitz; Shy Shorer; Michael Gutermacher; Ludvig Lazar; Ilan Erez; Robert Jedeikin; Enrique Freud
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  49     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-07     Completed Date:  2002-06-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  262-9     Citation Subset:  IM    
Department of Anesthesia and Critical Care Medicine, Meir Hospital, Kfar Saba, Israel.
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MeSH Terms
Anesthesia, Spinal / methods*
Apnea / etiology
Child, Preschool
Infant, Newborn
Infant, Premature
Intraoperative Complications / etiology
Postoperative Complications / etiology

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