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

Authors

DOI:

https://doi.org/10.3126/jpahs.v8i2.37690

Keywords:

Hemodynamic Changes, Modified Bromage Scale

Abstract

Introduction: Introduction: Spinal anesthesia has become the anesthesia of choice for most of the surgeries of the abdominal-pelvic region.  Cited with benefits such as lesser risks of apnea, minimal cardiopulmonary alteration, and abnormalities associated with neurocognitive development, it incorporates all components of balanced anesthesia, especially in pediatric surgeries. Encouraging results on the safety, efficacy, and feasibility of spinal anesthesia has increased its utility. The objective of our study was to assess the hemodynamic change occurring in children below four years undergoing lower abdominal and pelvic surgeries following spinal anesthesia.

Method: This is a cross-sectional study conducted over 2 years and includes children undergoing surgery of the lower abdomen in Kathmandu Model Hospital. 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 (modified Bromage scale) and complications.

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

Conclusion: Spinal anesthesia in small children showed minimal variation in intraoperative and postoperative hemodynamics and is a safer mode of anesthesia with sparing of respiratory alterations seen with general anesthesia.

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Author Biographies

Rikal Man Shrestha, Kathmandu Model Hospital, Kathmandu, Nepal

Senior Consultant, Department of Anesthesiology

Sunita Gurung, Kathmandu Model Hospital, Kathmandu, Nepal

Senior Registrar, Department of Anesthesiology

Sujan Surya Prajapati, Kathmandu Model Hospital, Kathmandu, Nepal

Consultant, Dept. of Anesthesiology

Biplav Pokharel, Kathmandu Model Hospital, Kathmandu, Nepal

Medical Officer, Dept. of Anesthesiology

Indra Kumar Shrestha, Kathmandu Model Hospital, Kathmandu, Nepal

Medical Officer, Dept. of Anesthesiology

Manoj Krishna Shrestha, Kathmandu Model Hospital, Kathmandu, Nepal

Senior Consultant Pediatric Surgeon

Sadikshya Ghimire, Nepal Mediciti Hospital, Lalitpur, Kathmandu, Nepal

Medical Officer

Brahma Dev Jha, Kathmandu Model Hospital, Kathmandu, Nepal

Head of Dept., Dept. of Anesthesiology

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Published

2021-06-10

How to Cite

Shrestha, R. M., Gurung, S., Prajapati, S. S., Pokharel, B., Shrestha, I. K., Shrestha, M. K., Ghimire, S., & Jha, B. D. (2021). Hemodynamic changes after spinal anesthesia in children below the age of four years. Journal of Patan Academy of Health Sciences, 8(2), 91–97. https://doi.org/10.3126/jpahs.v8i2.37690

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Section

General Section: Original Articles