Department of Anesthesia and Intensive Care, University of Antananarivo, Antananarivo, Madagascar.
Surgical Intensive Care, CHU Joseph Ravoahangy Andrianavalona, BP 4150 - 101, Antananarivo, Madagascar.
BMC Res Notes. 2020 Oct 21;13(1):491. doi: 10.1186/s13104-020-05330-9.
The aim of this study was to present the first cases of spinal anesthesia, in newborns and infants, preterm/ex-prematures, in order to determine its feasibility and its potential harmlessness, in Antananarivo-Madagascar. Indeed, spinal anesthesia is a low cost technique and can limit respiratory complications, postoperative apnea a contrario with pediatric general anesthesia which can lead to perioperative risks.
In a retrospective, descriptive, 7-year (2013 to 2019) period study, conducted in the University Hospital Joseph Ravoahangy Andrianavalona, 69 patients' data files planned to have spinal anesthesia were recorded. These pediatric patients were predominantly male (sex ratio = 2.8) and 37 [28-52] days old. The smallest anesthetized child weighed 880 g; the youngest was 4 days old. Twenty-seven (27) of them were premature and 20.3% presented respiratory diseases. They were mostly scheduled for hernia repair (90%). Spinal anesthesia was performed, with a Gauge 25 Quincke spinal needle, after 2 [1-2] attempts with hyperbaric bupivacaine of 4 [3.5-4] mg. Failure rate was 5.8%. The heart rate was stable throughout perioperative period and no complications were observed.
本研究旨在介绍首例在马达加斯加首都塔那那利佛进行的新生儿和早产儿的脊髓麻醉，以确定其可行性和潜在无害性。事实上，脊髓麻醉是一种低成本的技术，可以减少呼吸并发症，与可能导致围手术期风险的小儿全身麻醉相比，术后呼吸暂停的风险较低。
在一项回顾性、描述性的 7 年（2013 年至 2019 年）研究中，在约瑟夫·拉瓦奥哈尼昂亚纳瓦洛纳大学医院记录了 69 名计划接受脊髓麻醉的患者的数据文件。这些儿科患者主要为男性（性别比为 2.8），年龄为 37 [28-52] 天。接受麻醉的最小婴儿体重为 880g，最小的仅 4 天大。其中 27 人为早产儿，20.3%的患儿患有呼吸系统疾病。他们大多计划接受疝修补术（90%）。使用 25 号 Quincke 脊髓针进行了脊髓麻醉，在进行 2 [1-2] 次尝试后，使用 4 [3.5-4] mg 的布比卡因进行了高压麻醉。失败率为 5.8%。整个围手术期心率保持稳定，未观察到并发症。
