Continuous caudal anesthesia for inguinal hernia repair in former preterm infants.
OBJECTIVE
To determine the feasibility of continuous caudal anesthesia with 2-chloroprocaine in conscious former preterm infants undergoing inguinal hernia repair.


METHODS
Prospective study.


METHODS
University-affiliated children's hospital.


METHODS
Ten former preterm infants, ASA physical status II and III, who were 35 to 49.5 weeks postconceptional age at the time of surgery.


METHODS
Caudal anesthesia was administered via an indwelling catheter using a loading dose of 1 ml/kg (30 mg/kg) of 3% 2-chloroprocaine, followed by incremental doses of 0.3 ml/kg (9 mg/kg) to achieve a level of T4 to T2. The block was maintained by a minimum infusion rate of 30 mg/kg/hr (1 ml/kg/hr) of the same local anesthetic solution.


RESULTS
The mean cumulative dose of 2-chloroprocaine was 2.8 +/- 1.0 ml/kg/hr (84 +/- 30 mg/kg/hr) infused over a mean duration of 95 +/- 35 minutes. Serum cholinesterase concentration and plasma 2-chloroprocaine concentration were measured in five infants.


CONCLUSIONS
Three percent 2-chloroprocaine can be used effectively for continuous caudal anesthesia in conscious, former preterm infants for inguinal hernia and penoscrotal surgical procedures lasting 85 to 170 minutes.
Henderson
K
K
Department of Anaesthesia, Harvard Medical School, Boston, MA.
Sethna
N F
NF
Berde
C B
CB
D000763:Anesthesia, Caudal; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D002802:Cholinesterases / Q000097:blood; D005865:Gestational Age; D006339:Heart Rate / Q000187:drug effects; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D011343:Procaine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000494:pharmacology; D011446:Prospective Studies
D000779:Anesthetics, Local; D011343:Procaine; C004616:chloroprocaine; D002802:Cholinesterases