Paediatric spinal anaesthesia: Difference between revisions

Cardiovascular changes related to the SA are less common in children than in adults. In children under 5 years of age, minimal changes in heart rate and blood pressure have been reported.<ref name=":5" />^,<ref>Dohi S, Naito H, Takahashi T. Age-related changes in blood pressure and duration of motor blockade in spinal anesthesia. Anesthesiology 1979; 50: 319-23.</ref>^,<ref>Oberlander TF, Berde CB, Lam KH, Rappaport LA, Saul JP. Infants tolerate spinal anesthesia with minimal overall autonomic changes: analysis of heart rate variability in former preterm infants undergoing hernia repair. Anesth Analg 1995; 80: 20-7.</ref>^, 5,12,13 In older patients (>8 years old), the sympathetic block can induce bradycardia or hypotension. A few studies of SA in newborns have noted hypotension ten minutes after injection of the local anaesthetic. Cardiovascular changes due to spinal block are generally short lasting and respond to a bolus of intravenous fluid (10ml.kg-1).14 Cardiovascular stability in infants undergoing SA is probably related to smaller venous capacitance in the lower limbs leading to less blood pooling, and to relative immaturity of the sympathetic nervous system resulting in less dependence on vasomotor tone to maintain blood pressure.