Postoperative Apnoea in Infants

Abstract

Past studies concerning postoperative apnoea in infants were identified and reviewed. A total of only 200 former preterm infants having minor surgery under general anaesthesia have been prospectively studied. The incidence of apnoea after general anaesthesia is approximately 30%, and is inversely related to postconceptual age. A large number of term infants have been studied, and the incidence of postoperative apnoea is very low. The initial apnoea is always within 12 hours of surgery, though only one study has collected data beyond this length of time. Past history of apnoea episodes, bronchopulmonary dysplasia, anaemia or neurological disease may be associated with an increased risk, though current evidence is not strong. No patient characteristic apart from postconceptual age has enough sensitivity and specificity to identify a high-risk group. The use of spinal anaesthesia or methylxanthines may reduce the incidence of postoperative apnoea, but again the evidence is not strong. Recommendations concerning the timing of elective surgery and the use of postoperative respiratory monitoring in the former preterm infant can only be made cautiously in view of the paucity of data on which to base them.

The effects of aminophylline on bispectral index during inhalational and total intravenous anaesthesia*

“…Aminophylline is usually used in anaesthetic practice to treat bronchospasm [1, 2] and in preterm neonates to decrease the incidence of postoperative apnoea [3, 4]. However, empirical evidence suggests that aminophylline given at the end of surgery shortens recovery time from general anaesthesia and improves the quality of recovery [5–9].…”

Safety of Percutaneous Tendoachilles Tenotomy Performed Under General Anesthesia on Infants With Idiopathic Clubfoot

“…8,[11][12][13] Cote´et al performed a combined analysis of 8 prospective studies. Many of the current anesthesia guidelines are from the general surgery literature regarding inguinal hernia repair in the OR, which is a notably longer case than PTT with more known complications.…”

“…2,3 This procedure is commonly performed with the patient awake in a clinic setting with the use of a topical anesthetic and a post-tenotomy injection of a local anesthetic before cast application. [5][6][7][8][9][10] PCA is defined as the gestational age (GA) combined with the postnatal age. There is also evidence that performing potentially painful procedures in infants under adequate pain control may lessen the future pain response as an infant.…”

Das ehemalige Frühgeborene mit Leistenhernien

“…Von verschiedenen Autoren [39,43,46,63,65,75] werden unterschiedliche Angaben über die Häufigkeit (20-40%) und die Dauer der Gefährdung (postkonzeptionelles Alter 44-60 Wochen) gemacht. Auch die "kombinierte Analyse" von Coté et al [13] mit 225 Patienten aus 8 Studien kommt zu keiner einfachen praktischen Empfehlung.…”

“…Die vorhandenen wissenschaftlichen Untersuchungen umfassen nur sehr wenige Patienten, die verwendeten Kriterien sind uneinheitlich, und die meisten Studien sind unkontrolliert [39,43,46,63,65,75]. Die Ergebnisse sind zudem sehr stark von lokalen Verhältnissen und persönlichen Vorlieben und Fähigkeiten abhängig.…”