[Isobaric 0.5% bupivacaine for spinal anesthesia in pediatric outpatient surgery of 6 to 12 year old children: a prospective study.].
OBJECTIVE
Spinal anesthesia produces deep intra-operative analgesia in children and, when combined with general anesthesia, decreases perioperative anesthetics and opioids requirements. This prospective study aimed at evaluating clinical characteristics of spinal anesthesia with 0.5% racemic bupivacaine in 40 children, aged 6 to 12 years.


METHODS
Participated in this prospective study, 40 patients aged 6 to 12 years submitted to spinal anesthesia with 0.5 mg.kg-1 of 0.5% plain bupivacaine. The following parameters were evaluated: onset of analgesia, motor block, duration of effects, level of cephalad spread, cardiovascular changes, headache and transient neurological symptoms.


RESULTS
Onset time was 2.60 +/-1.28 min. Analgesia duration was 4.51 +/- 0.89 h. Time for ambulation was 4.04 +/- 0.83 h. PACU stay was 44.39 +/- 43.13 min. Motor block duration was 2.50 +/- 0.83 h. Sensory block level varied from T9 to T4 (Mode=T6). Motor block onset was less than three minutes in all children. All of them presented motor block grade 3 (modified Bromage Score) at the beginning of the surgery. Over 70% of all patients recovered to motor block 3 or 2 at surgery completion. No patient showed oxygen desaturation or arterial hypotension. Bradycardia was observed in two patients. There has been one motor block failure. There were no PDPH or transient neurological symptoms.


CONCLUSIONS
In our study, 0.5% isobaric bupivacaine induced a safe anesthesia in patients aged 6 to 12 years in outpatient procedures, with a high success rate, short-lived motor block and a low incidence of side effects. Our results have shown that spinal anesthesia is a safe and very easy technique for children between 6 and 12 years of age for outpatient procedures.
Imbelloni
Luiz Eduardo
LE
Casa de Saúde Santa Maria.
Vieira
Eneida Maria
EM
Beato
Lúcia
L
Zapatta
Carlos
C