First Realizations of Spinal Anesthesia in Neonates and Infants - Preterms or Ex prematures - in Antananarivo, Madagascar
Abstract Objective: The aim of this study was to describe the first realizations of spinal anesthesia in neonates and infants (preterms or ex prematures) in Antananarivo - Madagascar, because spinal anesthesia – a low cost technique – can limit respiratory complications and postoperative apnea and also general anesthesia can present perioperative risks for pediatric patients.Results: In a retrospective, descriptive, seven-year (2013 to 2019) period study, conducted in the University Hospital Joseph Ravoahangy Andrianavalona, data files of 69 babies 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 (97.1%). 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% needing general anesthesia conversion. The heart rate was stable throughout perioperative period and no complications were observed.