THE SPREAD OF SPINAL ANESTHESIA IN YOUNG PATIENTS

Abstract

Prediction of the final level of a spinal anesthesia is poor, especially in young patients. However, spread to a predictable segmental level which avoids hemodynamic complications would be a useful characteristic. The spread of spinal anesthesia with hyperbaric dibucaine (Neo-percamin S®) with epinephrine was studied retrospectively in 370 adolescents (ASA class 1 or 2) a ged 6_??_20 years old. Spinal anesthesia was performed under lateral position and using a 21 gauge metal spinal needle. Age, sex, body weight, height, injected site (L2-3, L3-4 or L4-5) and volume (0.5_??_2.0ml) were investigated. The maximum spread of analgesia level was assessed by pinprick method. Wide variation in the spread of the block has been observed, even when the same space has been used for injection, or same volume of local anesthetic has been used. Among investigated factors, height and body weight showed relatively high correlation to the level of spinal anesthesia. However, injection site and volume of local anesthetic were also important factors in younger ages (under 10 yr) was obserbed. These results suggest that the hyperbaric dibucaine with epinephrine solution for spinal anesthesia in adolescents may have a tendency to produce an unexpectedly extensive spread of anesthesia.