Hemodynamic changes after spinal anesthesia in children below the age of four years

Spinal anesthesia in small children

Abstract

Introduction: Spinal anesthesia has become the anesthesia of choice for most of the surgeries of the abdominal-pelvic region. It is cited with benefits such as lesser risks of apnea, cardiopulmonary alteration, and abnormalities associated with neurocognitive development. Encouraging results on safety, efficacy, and feasibility of spinal anesthesia has further achieved increasing utility as it provides all components of balanced anesthesia. The objective of this study was to assess the hemodynamic changes in children below four years of age undergoing lower abdominal and pelvic surgeries following spinal anesthesia.

Method: This is a cross-sectional study. The study was conducted over a duration of 2 years and includes 58 pediatric patients aged 2 days to 44 months undergoing surgery of the lower abdomen and lower extremity. The information was data regarding patients' demography, hemodynamic status prior, during, and after the procedure of spinal anesthesia, measuring systolic blood pressure (SBP), diastolic blood pressure (SBP), mean arterial pressure (MAP), heart-rate (HR), sensory and motor block characteristics and complications.

Result: The intraoperative and postoperative hemodynamics did not show major differences. The mean peak sensory level was T4 (C7-T10) at the time of the block. Recovery of sensory and motor block was complete in all patients. Modified Bromage scale was 1 in 57(98.27%), 2 hours post-surgery.  The average duration of the block was 75 minutes (30-180). 1(1.72%) patient developed apnea at the time of surgery.

Conclusion: Spinal anesthesia is found to be a safe and effective form of anesthesia. 

Keywords: bromage scale, hemodynamic changes, spinal anesthesia