Assessing the Safety and Efficacy of Spinal Anesthesia in Preterm and Term Neonates: A Multicenter Experience

Abstract

Background: Worldwide, the incidence of premature birth is increasing with its attending congenital anomalies, so complex surgical interventions to manage these congenital anomalies or complications are usually performed at early days of life. Neonates are vulnerable to apnea, and congenital cardiopulmonary problems and they have higher morbidity and mortality compared to older children and adults etc. In the preterm neonate, the risk of bronchopulmonary dysplasia and apnoea make their management complex and this is further compounded by their smaller size. Objective of study: The aim of the study was to determine the safety and efficacy of spinal anesthesia among neonates. Methodology: The study is a prospective study conducted in three tertiary health Institutions in northeast Nigeria. It includes all neonates scheduled for surgery amenable under SA. Sociodemographic variables, Haemodynamic variables, duration of surgery, and complications observed were all recorded. Results: Spinal anaesthesia SA was done in 230 patients, 90% of the patients were term, and only 10% were preterm. The majority were male with a mean weight of 3002 ± 660 grams and a mean age of 14.51±7.28 days. SA was successful in 93% of the patients in the first attempt. Heart rate, mean arterial pressure and oxygen saturation remained stable all through the duration of surgery. About 6% of the patients were converted to General Anaesthesia GA on account of prolonged surgery. The highest level of sympathetic block was recorded at the level of T4 while the lowest was at T6. Herniotomy was the most common surgery performed. The surgery lasted an average of 72 ± 28 minutes. No complication was recorded. Conclusion: Spinal anaesthesia provides a safe and reliable option for neonates who may require surgery early in life to improve their chances of survival. It serves as an alternative to GA with enhanced haemodynamic stability in this fragile population.