Use of spinal anaesthesia in paediatric patients: a single centre experience with 1132 cases

Background: Spinal anaesthesia has been used in children for over 100 years and in the last two decades its popularity for newborns and infants has increased, but there are still unanswered questions with the technique. Methods: We evaluated the characteristics of spinal block including ease of performance, efficacy, adverse effects and complications in 1132 children, aged 6 months to 14 years, undergoing surgery in the lower part of the body. Local ethical committee approved the protocol of this prospective study, and parents gave written informed consent and older children their assent. All patients were sedated with midazolam, thiopental or propofol intravenously during spontaneous ventilation. No inhalation anaesthetics were used. Spinal block was performed with 0.5% hyperbaric bupivacaine at a dose of 0.2 mg(.)kg(-1) Results: Efficacy, safety and ease of performance of the spinal block were shown to be satisfactory in most children. Only 27 of the 1132 children needed any supplementation. The incidence and severity of complications was low. Only nine of 942 children, <10 years of age and eight of 190 children, 10 years or older, developed hypotension. The incidences of postdural puncture headache, in five of the 1132 children, and backache, in nine of the 1132, were low. No other neurological complications were reported. Conclusions: Spinal anaesthesia with hyperbaric bupivacaine is a feasible anaesthetic method in children for surgery in the lower part of the body.