The effectiveness and safety of spinal anaesthesia in the pyloromyotomy procedure.
BACKGROUND
Hypertrophic pyloric stenosis is a relatively common disorder of the gastrointestinal tract in infancy, causing projectile vomiting and metabolic abnormalities. Surgical management in the form of pyloromyotomy under general anaesthesia has been reported as safe for relieving the obstructed bowel. A number of studies have demonstrated the advantages of spinal anaesthesia over general anaesthesia in high risk infants undergoing minor infraumbilical surgery. The purpose of this study was to evaluate spinal anaesthesia as an alternative option to general anaesthesia in infants undergoing pyloromyotomy.


METHODS
Twenty-five infants undergoing pyloromyotomy under spinal anaesthesia were studied. Haemodynamic and respiratory parameters were noted before performing the spinal block, 5 min after the spinal block, and every 10 min after performing the spinal block; for a total period of 30 min. The spinal block was performed using spinal isobaric bupivacaine 0.5%, 0.8 mg.kg-1. Blood pressure, heart rate, respiratory rate and oxygen saturation values were recorded.


RESULTS
The sensory levels achieved ranged between T3-T5 thoracic segments within 6-8 min and were sufficient to perform surgery in 23 cases. There were no statistically significant differences in the oxygen saturation, systolic blood pressure and respiratory rate compared with before the spinal block and after 5, 10, 20 and 30 min.


CONCLUSIONS
This study proposes that spinal anaesthesia is an alternative option to general anaesthesia in infants undergoing pyloromyotomy, and should be considered in infants undergoing pyloromyotomy.
Somri
Mostafa
M
Department of Anaesthesiology, B'nai Zion Medical Center, B. Rappaport Institute, Faculty of Medicine, Technion, Haifa, Israel. somri_m@yahoo.com
Gaitini
Luis A
LA
Vaida
Sonia J
SJ
Malatzkey
Shelton
S
Sabo
Edmond
E
Yudashkin
Marina
M
Tome
Riad
R
D000768:Anesthesia, General; D000775:Anesthesia, Spinal; D002045:Bupivacaine; D006801:Humans; D006984:Hypertrophy; D007231:Infant, Newborn; D016343:Monitoring, Intraoperative; D011707:Pyloric Stenosis / Q000601:surgery*
D002045:Bupivacaine