Spinal anesthesia in 62 premature, former-premature or young infants--technical aspects and pitfalls.
نویسندگان
چکیده
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.
منابع مشابه
Aromatherapy as a Nutrition Improvement Approach in Premature Infants: A Short Review
Background: Literature presented numerous methods to promote nutrition in premature newborns. The aim of the review is to promote nutrition in premature newborns using numerous methods which have been suggested by systematic review. Materials and Methods: </...
متن کاملبررسی میزان بروز تولد نوزاد نارس، عوارض و سرانجام آنها در بیمارستانهای دانشگاه علوم پزشکی شیراز در سال 1999
ABSTRACT Premature labor is one of the great difficulties endangering the health of the society and undoubtedly one of the tragedies of the world since many people suffer from the consequences of prematurity. An analytic research was performed from the records of all premature infants (gestational age less than 37 weeks) who were admitted to hospital of Shiraz Medical University (Zeina...
متن کاملEffect of Massage on Weight Gain in Premature Infants
Introduction After the introduction of surfactant, the survival rate of preterm neonates has increased significantly. This issue attracted much attention towards this fragile population. Many studies have demonstrated that massage plays a role in the weight gain of preterm infants. This study compares the effect of massage therapy on infants who were massaged by a nurse or their mother with tho...
متن کاملSpinal Anesthesia in Preterm Infants Undergoing Herniorrhaphy, June 2009, AANA Journal
AANA Journal June 2009 Vol. 77, No. 3 199 Inguinal hernias are the most common diagnosis requiring surgical repair in children of all ages. Anesthetic management of premature infants is often difficult due to their comorbidities and propensity for apnea and bradycardia. General anesthesia has been shown to be associated with an increased incidence of postoperative adverse events. The purpose of...
متن کاملComparison of the Effects of Attachment Training for Mothers on the Behavioral Responses of Premature Infants: A Randomized Clinical Trial
Background: Premature infants are among high-risk groups in community who need to be hospitalized at intensive care units for survival and receiving basic or special care. Hospitalization at neonatal intensive care units (NICUs) unsettles the family and leads to the separation of parents from their infants. This study aimed to determine the effects of maternal attachment behaviors on the behavi...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Canadian journal of anaesthesia = Journal canadien d'anesthesie
دوره 49 3 شماره
صفحات -
تاریخ انتشار 2002