title: Cerebrospinal fluid volume in neonates undergoing spinal anaesthesia: a descriptive magnetic resonance imaging study.
abstract: BACKGROUND
  Spinal anaesthesia (SA) reduces the risk of postoperative apnoea after general anaesthesia in neonates. In 30% of patients, however, the duration of anaesthesia provided does not allow completion of surgery. When compared with term infants, formerly preterm neonates experience a shorter duration of anaesthesia after SA. A difference in the cerebrospinal fluid (CSF) volume between those two populations could explain this difference, but this has never been investigated. The study was designed to evaluate the relationship between the spinal CSF volume and patient characteristics in neonates.
  
  
  METHODS
  Sixty-seven neonates, aged 30-60 weeks postconception, were included in this study. Their spinal CSF volumes were calculated using magnetic resonance imaging, and these volumes were plotted individually against sex, term at birth, birth weight, current gestational age, civil age, and weight. Correlations between CSF volume and these variables were investigated.
  
  
  RESULTS
  Fifty-four neonates completed the study. The CSF volume was found to be closely and linearly correlated with weight and postconceptional age. The relationship between spinal CSF volume and weight can be described as follows: CSF volume (ml)=1.94 weight (kg)+0.13. The CSF volume was not correlated with sex, weight, or term at birth, nor with civil age.
  
  
  CONCLUSIONS
  The amount of spinal CSF in neonates can be estimated as 2 ml kg(-1) in both term and formerly preterm neonates. A difference in the CSF volume between them does not provide an explanation for a shorter duration of SA in the latter. Our findings reinforce weight-adjusted dosage of SA in neonates.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France cal-rochette@orange.fr.
authors.forename: A
authors.initials: A
authors.lastname: Rochette
authors.affiliation: Department of Anesthesia, McGill University Health Center, Montreal Children's Hospital, Montreal, Quebec, Canada.
authors.forename: M-P
authors.initials: MP
authors.lastname: Malenfant Rancourt
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Sola
authors.affiliation: Department of Pediatric Radiology, Arnaud de Villeneuve University Hospital, CHU de Montpellier, France.
authors.forename: O
authors.initials: O
authors.lastname: Prodhomme
authors.affiliation: Department of Pediatric Radiology, Arnaud de Villeneuve University Hospital, CHU de Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Saguintaah
authors.affiliation: Department of Medical Information, UMR 1044, CHU de Montpellier, France.
authors.forename: R
authors.initials: R
authors.lastname: Schaub
authors.affiliation: Department of Medical Information, UMR 1044, CHU de Montpellier, France.
authors.forename: N
authors.initials: N
authors.lastname: Molinari
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: X
authors.initials: X
authors.lastname: Capdevila
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Dadure
mesh_terms: D000367:Age Factors; D000768:Anesthesia, General; D000775:Anesthesia, Spinal / Q000379:methods*; D001049:Apnea / Q000517:prevention & control; D001835:Body Weight; D002555:Cerebrospinal Fluid; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies
keywords: anaesthesia, spinal; cerebrospinal fluid; infant