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Changes in tissue and cerebral oxygenation following spinal anesthesia in infants: a prospective study

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Abstract

Use of spinal anesthesia (SA) in children may address concerns about potential neurocognitive effects of general anesthesia. We used near-infrared spectroscopy (NIRS) to assess the effects of SA on cerebral and tissue oxygenation in 19 patients aged 7 ± 3 months. Prior to SA placement, NIRS monitors were placed on the forehead (cerebral) and the thigh (tissue). Intraoperative cerebral and tissue saturation were 73 ± 7 and 80 ± 11%, respectively, before SA placement. NIRS measurements were monitored every minute for 30 min after SA placement and modeled using mixed-effects linear regression. Regression estimates showed that cerebral saturation remained stable from 67% [95% confidence interval (CI) 63, 71%] after SA placement to 68% (95% CI 65, 72%) at the conclusion of monitoring. After SA placement, tissue saturation was elevated compared to baseline values; but further change [from 91% (95% CI 89, 93%) to 93% (95% CI 91, 95%) at the end of monitoring] was clinically non-significant. All patients breathed spontaneously on room air without changes in oxygen saturation. Blood pressure and heart rate decreased after SA placement, but no changes in hemodynamic parameters required treatment. These data provide further evidence of the neutral effect of SA on cerebral oxygenation 30 min after block placement.

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Funding

The study was funded by departmental resources.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43205, USA

    Alexander B. Froyshteter, Dmitry Tumin, Emmett E. Whitaker, David P. Martin, Mumin Hakim, Hina Walia, Tarun Bhalla & Joseph D. Tobias

  2. Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, USA

    Emmett E. Whitaker, David P. Martin, Tarun Bhalla & Joseph D. Tobias

  3. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, USA

    Dmitry Tumin

Authors
  1. Alexander B. Froyshteter
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  2. Dmitry Tumin
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  3. Emmett E. Whitaker
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  4. David P. Martin
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  5. Mumin Hakim
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  6. Hina Walia
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  7. Tarun Bhalla
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  8. Joseph D. Tobias
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Corresponding author

Correspondence to Dmitry Tumin.

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Ethics

Institutional Review Board approval at Nationwide Children’s Hospital (Columbus, OH, USA) number IRB16-00465 obtained on June 17, 2016.

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The authors have no conflict of interest to report.

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Froyshteter, A.B., Tumin, D., Whitaker, E.E. et al. Changes in tissue and cerebral oxygenation following spinal anesthesia in infants: a prospective study. J Anesth 32, 288–292 (2018). https://doi.org/10.1007/s00540-017-2446-8

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  • DOI: https://doi.org/10.1007/s00540-017-2446-8

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