Comparison of spinal anaesthesia with epidural anaesthesia in paediatric surgery.
202 children aged 2 months to 17 years, undergoing elective paediatric operations below the umbilicus, were allocated randomly to receive either spinal (SA) or epidural anaesthesia (EA). SA was more efficacious since 8 children of 102 needed supplementation with general anaesthesia, in contrast to EA where 24 children of 100 were supplemented with general anaesthesia and 6 with fentanyl. The haemodynamic stability was maintained during EA, whereas during SA 6 patients were given medication to increase heart rate/blood pressure. EA provided longer pain relief than SA in the recovery room. The incidence of postoperative side effects was similarly low following SA and EA. Complaints after discharge were also similar. General weakness (7% vs 8% after SA and EA, respectively), low back pain (6% vs 6%), headache (7% vs 4%), fever (6% vs 4%) and positional headache (PDPH) (5% vs 3%) were the most frequent side effects. PDPH was only observed following SA in children aged 11 years or older. Following EA, PDPH was also observed in the younger age group after accidental dural puncture. In conclusion, we prefer SA for minor paediatric operations due to its high efficacy.
Kokki
H
H
Department of Anaesthesiology, Kuopio University Hospital, Finland.
Hendolin
H
H
D000759:Adjuvants, Anesthesia; D000293:Adolescent; D000367:Age Factors; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000768:Anesthesia, General; D000775:Anesthesia, Spinal / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D005283:Fentanyl; D006261:Headache / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications
D000759:Adjuvants, Anesthesia; D005283:Fentanyl