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Age-based Local Anesthetic Dosing in Pediatric Spinal Anesthesia: Evaluation of a New Formula – A Pilot Study in Indian Patients

BACKGROUND: Spinal anesthesia is a safe alternative to general anesthesia and often the anesthetic technique of choice in many lower abdominal and lower limb surgeries in children. As the vertebral column and spinal cord grows variedly with age and not weight, we planned to administer an age-based d...

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Autores principales: Parthasarathy, S., Senthilkumar, T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594779/
https://www.ncbi.nlm.nih.gov/pubmed/28928560
http://dx.doi.org/10.4103/aer.AER_246_16
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author Parthasarathy, S.
Senthilkumar, T.
author_facet Parthasarathy, S.
Senthilkumar, T.
author_sort Parthasarathy, S.
collection PubMed
description BACKGROUND: Spinal anesthesia is a safe alternative to general anesthesia and often the anesthetic technique of choice in many lower abdominal and lower limb surgeries in children. As the vertebral column and spinal cord grows variedly with age and not weight, we planned to administer an age-based dosing schedule of hyperbaric bupivacaine in the intra-thecal space in select infra umbilical surgeries in children. The aim was to find out the efficacy and complications associated with this dosage. METHODOLOGY: Twenty-five pediatric patients between 2 and 12 years, posted for elective infra umbilical surgeries were given a sedation as a combination of effective doses of pentazocine, midazolam, and atropine. In all those patients, spinal anesthesia was administered at a dose of age/5 of hyperbaric bupivacaine. The number of attempts, the onset of blockade, the mean sensory level, and the duration of anesthesia were noted. Any other complications were also noted. RESULTS: The mean and standard deviation of age is 7.68 ± 2.49 years. Intra-thecal anesthesia was administered successfully in the first attempt in 88% of cases whereas the remaining needed the second attempt. Three patients needed intravenous ketamine of 0.25 mg/kg additionally for preoperative sedation. The sensory level was between T6 and T10 with a mean of T8.5. There were no intra-operative complications. In all patients, surgery was finished within the duration of anesthesia of approximately 60 min. There was no conversion to general anesthesia in any case, but a three patients required dose of 0.25 mg/kg of intravenous ketamine as a calming dose. CONCLUSION: Administration of age-based local anesthetic dosing of hyperbaric bupivacaine in the intra-thecal space by utilizing a new formula of age/5 (Partha formula) is successful in a pilot study in Indian children for infra-umbilical surgeries. There were no observed complications.
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spelling pubmed-55947792017-09-19 Age-based Local Anesthetic Dosing in Pediatric Spinal Anesthesia: Evaluation of a New Formula – A Pilot Study in Indian Patients Parthasarathy, S. Senthilkumar, T. Anesth Essays Res Original Article BACKGROUND: Spinal anesthesia is a safe alternative to general anesthesia and often the anesthetic technique of choice in many lower abdominal and lower limb surgeries in children. As the vertebral column and spinal cord grows variedly with age and not weight, we planned to administer an age-based dosing schedule of hyperbaric bupivacaine in the intra-thecal space in select infra umbilical surgeries in children. The aim was to find out the efficacy and complications associated with this dosage. METHODOLOGY: Twenty-five pediatric patients between 2 and 12 years, posted for elective infra umbilical surgeries were given a sedation as a combination of effective doses of pentazocine, midazolam, and atropine. In all those patients, spinal anesthesia was administered at a dose of age/5 of hyperbaric bupivacaine. The number of attempts, the onset of blockade, the mean sensory level, and the duration of anesthesia were noted. Any other complications were also noted. RESULTS: The mean and standard deviation of age is 7.68 ± 2.49 years. Intra-thecal anesthesia was administered successfully in the first attempt in 88% of cases whereas the remaining needed the second attempt. Three patients needed intravenous ketamine of 0.25 mg/kg additionally for preoperative sedation. The sensory level was between T6 and T10 with a mean of T8.5. There were no intra-operative complications. In all patients, surgery was finished within the duration of anesthesia of approximately 60 min. There was no conversion to general anesthesia in any case, but a three patients required dose of 0.25 mg/kg of intravenous ketamine as a calming dose. CONCLUSION: Administration of age-based local anesthetic dosing of hyperbaric bupivacaine in the intra-thecal space by utilizing a new formula of age/5 (Partha formula) is successful in a pilot study in Indian children for infra-umbilical surgeries. There were no observed complications. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5594779/ /pubmed/28928560 http://dx.doi.org/10.4103/aer.AER_246_16 Text en Copyright: © 2017 Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Parthasarathy, S.
Senthilkumar, T.
Age-based Local Anesthetic Dosing in Pediatric Spinal Anesthesia: Evaluation of a New Formula – A Pilot Study in Indian Patients
title Age-based Local Anesthetic Dosing in Pediatric Spinal Anesthesia: Evaluation of a New Formula – A Pilot Study in Indian Patients
title_full Age-based Local Anesthetic Dosing in Pediatric Spinal Anesthesia: Evaluation of a New Formula – A Pilot Study in Indian Patients
title_fullStr Age-based Local Anesthetic Dosing in Pediatric Spinal Anesthesia: Evaluation of a New Formula – A Pilot Study in Indian Patients
title_full_unstemmed Age-based Local Anesthetic Dosing in Pediatric Spinal Anesthesia: Evaluation of a New Formula – A Pilot Study in Indian Patients
title_short Age-based Local Anesthetic Dosing in Pediatric Spinal Anesthesia: Evaluation of a New Formula – A Pilot Study in Indian Patients
title_sort age-based local anesthetic dosing in pediatric spinal anesthesia: evaluation of a new formula – a pilot study in indian patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594779/
https://www.ncbi.nlm.nih.gov/pubmed/28928560
http://dx.doi.org/10.4103/aer.AER_246_16
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