Our experiences with spinal anesthesia in pediatric patients

Objectives: The aim of this study was to evaluate the characteristics of spinal anesthesia, including its efficacy, adverse effects and complications, in order to determine if it can be applied safely in pediatric patients at high-risk for general anesthesia. We emphasize our positive outcomes in children undergoing lower abdominal surgery in our previous experience. Methods: The perioperative data of 86 pediatric patients who received spinal anesthesia between 2007 and 2008 were scanned retrospectively. Demographic data, operation types, anesthetic applications, duration of surgery, motor blockade degree, two dermatomes regression time, postoperative analgesic requirements, adverse effects, and complications were recorded. Results: The operation time and two dermatomes regression times were found as 49.8 +/- 24.1 minutes and 73.0 +/- 21.9 minutes, respectively. At the end of the operation, motor blockade had disappeared in 17 patients and persisted in 68 patients. Block time was measured as 67.3 +/- 16.2 minutes in these patients. During the intraoperative period, hypotension was observed in two patients, and bradycardia occurred in one patient. Except for these, hemodynamic parameters did not change more than 20% from control values at any time. In three children, surgery was continued under general anesthesia. Forty-six patients required additional analgesic doses in the postoperative period. The time to first analgesic requirement was 2.3 +/- 1.2 hours. During the postoperative period, no hemodynamic or respiratory complications were observed. Conclusion: Spinal anesthesia continues to gain acceptance as an alternative to general anesthesia in children. However, we conclude that accumulated experience is required in order to apply this technique safely in pediatric patients. We emphasize the positive outcomes, adverse events and complications observed in our experience.