1 - Interno de Anestesiologia, Centro Hospitalar de Lisboa Central
2 - Assistente Hospitalar Graduado, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central
3 - Chefe de Serviço, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central
- Reunião Internacional 33 Annual ESRA Congress 2014 - Sevilha
Background: Spinal anesthesia (SA) in preterm infants has important advantages when compared with general anesthesia. In the current literature, there are reports of successful use of SA for infraumbilical and upper abdominal surgery in preterm neonates and former preterm. We report a case of spinal anesthesia in a former preterm infant.
Case Report:We present a case of relapsed inguinal hernia successfully repaired under SA in a 7-months-old preterm male (gestational age of 24 weeks) with severe bronchopulmonary dysplasia. The SA was performed under spontaneous breathing with light sevoflurane sedation. After positioning the child in the sitting position with minimal neck extension and sterile preparation, 0,5mg/kg of 0,5% Levobupivacaine was injected. The surgery was initiated after confirmation by pinprick that he didn’t feel pain. At the end of surgery an ultrasound guided ilioinguinal and iliohypogastric nerve block was performed using 2mL 0,125% levobupivacaine for postoperative analgesia. The surgery and the preoperative period were uneventful.
Discussion/Conclusion: Preterm infants have a higher risk of postoperative apneia and bradycardia after general anesthesia until a post conception age of 60 weeks. The present case illustrates the feasibility and effectiveness of SA in a former preterm infant, with no occurrence of complications. SA may be a challenging technique that demands knowledge and experience because of the specificities of this block in this special population.
Palavras Chave: Spinal Anesthesia, Premature