Neonatal anaesthesia: Difference between revisions

Inguinal hernia is common in premature neonates. The timing of surgery depends on the risk of incarceration, bowel strangulation or testicular atrophy versus the risk of postoperative apnoea and the potential harm to neurodevelopment. The major anaesthetic risk is post- operative apnoea, which has been shown to vary from 4.7% to 49% of patients.<ref name=":0" /><ref>Malviya S, Swartz J, Lerman J. Are all preterm infants younger than 60 weeks postconceptional age a risk for post-anesthetic apnea? Anesthesiology 1993; 78 1076–81.</ref> Some units prefer spinal anaesthesia for inguinal hernia repair, others use a balanced anaesthetic technique using general anaesthesia with intubation, supplemented with a regional technique. There is currently not enough evidence to show whether the incidence of apnoea is lower using spinal anaesthesia, and the choice is usually determined by local preference of the surgeon and anaesthetist.<ref>Craven PD, Badawi N, Henderson-Smart DJ, O’Brien M. Regional (spinal, epidural, caudal) versus general anaesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy. Cochrane Database Syst Rev 2003;3:CD003669.</ref>