Hyperbaric bupivacaine for spinal anaesthesia in 7-18 yr old children: comparison of bupivacaine 5 mg ml-1 in 0.9% and 8% glucose solutions.

We have compared two hyperbaric bupivacaine solutions for spinal anaesthesia in 7-18-yr-old school-aged children in a double-blind, randomized, parallel group, prospective study. Children were premedicated with diazepam orally. Half of the patients were sedated with either midazolam or thiopental. After lumbar puncture with a 27-gauge spinal needle, bupivacaine 5 mg ml-1 in either 0.9% or 8% glucose was injected in a dose of 0.3 mg kg-1. Maximum cephalad spread and regression of block were tested by transcutaneous electrical stimulation. Success rate, spread and duration of sensory block were similar in both groups. The highest median level of sensory block was T4 (10-90th percentiles T1-T7) in the 0.9% glucose group and T4 (T1-T5) in the 8% glucose group. Time to two segment regression of block was 83 (50-143) min in the 0.9% glucose and 85 (53-150) min in the 8% glucose group. The incidence of adverse effects was similar. Six children were given etilefrin to treat hypotension and six atropine for bradycardia. Nausea was associated with a high level of block. Shivering was detected in 16 children.