title: Apneas in Infants with Postconceptional Age bellow 60 Weeks Undergoing Herniorrhaphy.
abstract: OBJECTIVE
  Postoperative apnea is a major concern in infants undergoing surgery. In this study, we evaluated incidence and related factors for postoperative apnea in infants less than 60 weeks postconceptual age after herniorrhaphy.
  
  
  METHODS
  One-hundred fifty infants with post conceptional age (PCA) less than 60 weeks who underwent elective herniorrhaphy were studied over eight months in 2012. General anesthesia was induced by sevoflurane and maintained by remifentanil, atracurium, and N2O 60%. Postoperatively, they were monitored for two hours in the recovery room and ten hours in the ward using pulse oximetry and nasal capnography.
  
  
  RESULTS
  Totally, 31 (20.7%) cases of postoperative apnea were reported. By comparing the patients, factors associated with postoperative apnea included postconceptional age, birth weight, and history of apnea, oxygen therapy, metabolic diseases, icterus, or cardiac disease. Twenty-seven (18%) apnea cases occurred in recovery room in infants with gestational age (GA) of 35.64±2.73 weeks, while only four (2.6%) patients of GA 36.02±2.0 weeks developed delayed apnea).
  
  
  CONCLUSIONS
  In our study, the incidence of postoperative apnea following inguinal herniorrhaphy under general anesthesia in infants younger than 60 weeks PCA was 20.7%, which is considerable. We recommend longer surveillance and monitoring in recovery room for these infants with high-risk of postoperative apnea. This should be followed by evaluation of risk factors to determine the indication for elective intensive care unit transfer for longer-term monitoring of higher-risk patients.
authors.affiliation: Cardiac Anesthesia Research Center, Imam-Reza Hospital, School of Medicine, Mashhad University of Medical Science , Mashhad, Iran.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Gharavi-Fard
authors.affiliation: Cardiac Anesthesia Research Center, Imam-Reza Hospital, School of Medicine, Mashhad University of Medical Science , Mashhad, Iran.
authors.forename: Mehryar
authors.initials: M
authors.lastname: Taghavi-Gilani
authors.affiliation: Cardiac Anesthesia Research Center, Imam-Reza Hospital, School of Medicine, Mashhad University of Medical Science , Mashhad, Iran.
authors.forename: Samira
authors.initials: S
authors.lastname: Kazemi
authors.affiliation: Cardiac Anesthesia Research Center, Imam-Reza Hospital, School of Medicine, Mashhad University of Medical Science , Mashhad, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Razavi
keywords: Anaesthesia, General; Apnea; Herniorrhaphy; Infant; Postoperative Complications; Prematurity