Apnea following spinal anaesthesia in two former pre-term infants.
OBJECTIVE
To report the occurrence of apnea and bradycardia in two former pre-term infants who received spinal anaesthesia without inhalational or intravenous anaesthetic agents during inguinal herniorrhaphy.


METHODS
Two former pre-term infants who had no recent history of apnea or bradycardia and who had been discharged from the hospital presented for anaesthetic care during inguinal herniorrhaphy. Spinal anaesthesia using 1 mg.kg-1 tetracaine in dextrose 10% was performed. A sensory level of T4-6 was obtained in both infants. Neither infant received intravenous, oral, or inhalational agents for sedation. Five to ten minutes after placement of the spinal block, the two infants had frequent episodes of apnea and bradycardia. No change in the sensory level of spinal anaesthesia was noted. The apnea and bradycardia continued for a variable time into the postoperative period. Caffeine benzoate 10 mg.kg-1 was administered to one infant. Other than the apnea and bradycardia, both infants had uncomplicated postoperative courses.


CONCLUSIONS
Apnea can occur when spinal anaesthesia is used as the sole anaesthetic technique in the former pre-term infant. Appropriate monitoring for such problems based on the infant's post-conceptual age is suggested.
Tobias
J D
JD
Department of Child Health, University of Missouri, Columbia 65212, USA. JosephvTobias@muccmail.missouri.edu
Burd
R S
RS
Helikson
M A
MA
D000367:Age Factors; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D001049:Apnea / Q000139:chemically induced*; D001565:Benzoates / Q000627:therapeutic use; D001919:Bradycardia / Q000139:chemically induced; D002110:Caffeine / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007431:Intraoperative Complications; D008297:Male; D009407:Nerve Block / Q000009:adverse effects; D013748:Tetracaine / Q000009:adverse effects*; D013997:Time Factors
D000779:Anesthetics, Local; D001565:Benzoates; D000697:Central Nervous System Stimulants; D004338:Drug Combinations; D013748:Tetracaine; D002110:Caffeine; C025741:caffeine, sodium benzoate drug combination