Feasibility, safety and outcome of inguinal hernia repair under spinal versus general anesthesia in preterm and term infants
| Autor: | Silvia Ceccanti, Denis A. Cozzi, Alice Cervellone, Maria Vittoria Pesce |
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| Rok vydání: | 2021 |
| Předmět: |
Hernia
Inguinal Pilot Projects Anesthesia General Single Center Anesthesia Spinal Sevoflurane premature Fentanyl 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Humans spinal anesthesia Bupivacaine infants business.industry Infant Newborn Infant Spinal anesthesia General Medicine medicine.disease general anesthesia Inguinal hernia inguinal hernia repair neonate 030220 oncology & carcinogenesis Anesthesia Pediatrics Perinatology and Child Health Feasibility Studies Operative time Surgery Propofol business medicine.drug |
| Zdroj: | Journal of Pediatric Surgery. 56:1057-1061 |
| ISSN: | 0022-3468 |
| Popis: | Background Inguinal hernia repair (IHR) is a common operation in preterm and term infants. Recently, spinal anesthesia (SA) has been proposed as an alternative to avoid exposure to general anesthesia (GA) during early life. The aim of this study was to compare surgical outcomes of open IHR performed under SA versus GA in neonates and infants, and to detect criteria to predict the success or failure of SA. Materials and methods This is a 6-year, single center, nonrandomized interventional study (2013–2019). SA was performed with 0.5% bupivacaine. GA was given using propofol, fentanyl, sevoflurane, and laryngeal mask. Patient demographics, operative time, intraoperative events related to surgery or anesthesia, and complications were analyzed at short and long-term follow-up. Results 68 infants (78 IHR) and 37 infants (44 IHR) received SA and GA at the discretion of the anesthesiologist, respectively. SA failure rate was 9%, and positively correlated with weight at surgery (p = 0.001; rp = 0.38). Conversion from SA to GA occurred in 4 (6%) patients owing to prolonged operative time (43.75 ± 4.8 vs 23.02 ± 11.3 min; p = 0.0006). There were no differences regarding operative time and intra- and postoperative complications among the two groups at mean follow-up of 18.53 ± 21.9 months. Conclusions This pilot study confirms that SA is safe, effective and not detrimental to surgical outcome of neonates and infants undergoing IHR. Additionally, it may help further define what patients may have a successful SA. Our experience suggests that SA is especially suitable in infants weighing Level of evidence Level II. |
| Databáze: | OpenAIRE |
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