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Abstract
Background and Aims Neonatal anesthesia needs understanding of the rapidly changing physiology of the neonates, the pathology of the coexisting diseases, and the pharmacology of the medications used. The multisystem immaturity of this age generates developmental differences in the drug handling and response compared to older children(1,2). Regional anesthesia in pediatrics may be beneficial(3) to avoid airway manipulation and respiratory depression. It also improves intraoperative pain management or decreases the potential neurotoxic effects of intravenous or inhaled general anesthetics(4). So, this study was designed to allow an alternative to general anesthesia. The objectives were to compare spinal versus general anesthesia in neonates undergoing infraumbilical surgeries regarding hemodynamics and complications.
Methods Our study was a comparative single-blinded clinical trial included 36 mature neonates who were planned for infraumbilical surgeries. They were randomly allocated into two equal groups.Spinal anesthesia(SA) group was received intrathecal bupivacaine 0.5% in a dose of 1 mg/kg. General anesthesia(GA) group was received inhalational sevoflurane for induction and maintenance and Paracetamol 15 mg/kg IV infusion for analgesia. Ethical committee approval was obtained.
Results Intraoperative hemodynamics was statistically significantly more stable in SA group. In SA group bloody tap occurred once. While in GA group, two patients had hypoxia. The intra-operative complications were statistically non-significant between both groups. Post-operative complications were statistically significantly lower in SA group compared to GA group (p < 0.05). Postoperative heart rate (HR) was statistically significantly lower in the SA group compared to the GA group (p< 0.05).
Comparison between patient characteristics in SA and GA groups: demographic data and duration of surgery
Post-operative complications (number of patients) in both groups
Types of post-operative complications in both groups
Conclusions Spinal anesthesia is a good alternative to general anesthesia in neonates for infraumbilical surgeries.