RecruitingNot ApplicableNCT06871995

Efficacy, Safety and Limitations of Spinal Block for All Infants Under 3 Months

Efficacy, Safety and Limitations of Spinal Block When Used for All Infants Under 3 Months of Age Scheduled for Lower Abdominal Surgery

Sponsor

Ain Shams University

Enrollment

90 participants

Start Date

Mar 1, 2025

Study Type

INTERVENTIONAL

Conditions

Anesthesia

Summary

Spinal anesthesia (SA) has been shown to be a viable alternative to general anesthesia (GA) for infants and children for a variety of surgical procedures. SA serves to avoid some of the potential risks of GA including the need for airway manipulation, hemodynamic instability, postoperative apnea, and exposure to medications that may cause neurotoxicity .SA allows the prevention and reduction of perioperative complications even if its duration is an important limiting factor. Because of this limitation, short surgery is the most indicated under SA . Premature infants and neurologically impaired children account for the majority of spinal anesthetics used today . This study evaluates the effectiveness, safety and limitations of spinal anesthesia when used for all infants under 3 months undergoing lower abdominal surgery at Ain Shams University Hospitals.

Eligibility

Min Age: 1 DayMax Age: 3 Months

Inclusion Criteria3

Age under 3 months.
Physical status: American Society of Anesthesiologists I - II.
Elective lower abdominal surgeries such as: hernia, hydrocele, undescended testis

Exclusion Criteria3

Patient's parents or legal guardian refusing to do this specific procedure.
Coagulopathy, use of anti-coagulant or antiplatelet therapy.
Infection at the site of injection.

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Interventions

PROCEDUREspinal block

All patients will receive spinal anesthesia via midline approach with patients in sitting position established by assistant under complete aseptic conditions. A subcutaneous bleb using Lidocaine 1% through the needle of an insulin syringe followed by minor skin scratch to will help avoiding possible intrathecal dermoid implantation . A lumbar puncture will be performed in L4-L5 or L5- S1 interspace using 25-G 25-mm pencil-point spinal needle . Depth of epidural space is anticipated at 0.1 mm/kg . After getting free flow of cerebrospinal fluid (CSF) hyperbaric bupivacaine (0.5%) in a dose of 0.5 mg/kg (0.1 ml/kg) will be slowly injected in the subarachnoid space . The end of the injection will be taken as time zero for further data recording.