Regional (spinal, epidural, caudal) versus general anaesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy

Abstract

There is no reliable evidence from the trials reviewed concerning the effect of spinal as compared to general anaesthesia on the incidence of post-operative apnoea, bradycardia, or oxygen desaturation in ex-preterm infants undergoing herniorrhaphy. The estimates of effect in this review are based on a total population of only 108 patients or fewer.A large well designed randomised controlled trial is needed to determine if spinal anaesthesia reduces post-operative apnoea in ex-preterm infants not pretreated with sedatives. Adequate blinding, follow up and intention to treat analysis are required.

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

“…One of the main arguments against suggested that spinal anesthesia is technically difficult and not reliable in those infants [23,24]. Thus, the aim of this study was to demonstrate that spinal anesthesia is particularly suitable in infants at a higher risk, and moreover even in cases of hernia incarceration.…”

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

“…One of the main arguments against suggested that spinal anesthesia is technically difficult and not reliable in those infants [23,24]. Thus, the aim of this study was to demonstrate that spinal anesthesia is particularly suitable in infants at a higher risk, and moreover even in cases of hernia incarceration.…”

A critical review of premature infants with inguinal hernias: optimal timing of repair, incarceration risk, and postoperative apnea

“…In addition, this study was inadequate to assess for the incidence of contralateral hernia in patients who had undergone unilateral herniorrhaphy. Another weakness was that few patients had a regional anesthesia, which may have affected our apnea rate, although a recent meta-analysis showed no difference in regional vs general anesthesia in former preterm infants undergoing herniorrhaphy [20]. Finally, reasons for the prolonged intubation in infants undergoing repair before NICU discharge were not clearly documented and we were not able to determine the true apnea rate in this subset of patients.…”

Anestesia neuroaxial comparada à anestesia geral para procedimentos na metade inferior do corpo: revisão sistemática de revisões sistemáticas

“…Only 27 systematic reviews were read in full text, but 9 were excluded because they were not compatible with the inclusion criterion, and 8 were published in more than one journal or cited more than once in databases. This process left us with 10 systematic reviews for qualitative analysis [8][9][10][11][12][13][14][15][16][17] . Kappa statistics for screening systematic reviews was 0.82.…”

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

“…One of the main arguments against suggested that spinal anesthesia is technically difficult and not reliable in those infants [23,24]. Thus, the aim of this study was to demonstrate that spinal anesthesia is particularly suitable in infants at a higher risk, and moreover even in cases of hernia incarceration.…”

A critical review of premature infants with inguinal hernias: optimal timing of repair, incarceration risk, and postoperative apnea

“…In addition, this study was inadequate to assess for the incidence of contralateral hernia in patients who had undergone unilateral herniorrhaphy. Another weakness was that few patients had a regional anesthesia, which may have affected our apnea rate, although a recent meta-analysis showed no difference in regional vs general anesthesia in former preterm infants undergoing herniorrhaphy [20]. Finally, reasons for the prolonged intubation in infants undergoing repair before NICU discharge were not clearly documented and we were not able to determine the true apnea rate in this subset of patients.…”

Anestesia neuroaxial comparada à anestesia geral para procedimentos na metade inferior do corpo: revisão sistemática de revisões sistemáticas

“…Only 27 systematic reviews were read in full text, but 9 were excluded because they were not compatible with the inclusion criterion, and 8 were published in more than one journal or cited more than once in databases. This process left us with 10 systematic reviews for qualitative analysis [8][9][10][11][12][13][14][15][16][17] . Kappa statistics for screening systematic reviews was 0.82.…”

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

“…One of the main arguments against suggested that spinal anesthesia is technically difficult and not reliable in those infants [23,24]. Thus, the aim of this study was to demonstrate that spinal anesthesia is particularly suitable in infants at a higher risk, and moreover even in cases of hernia incarceration.…”

A critical review of premature infants with inguinal hernias: optimal timing of repair, incarceration risk, and postoperative apnea

“…In addition, this study was inadequate to assess for the incidence of contralateral hernia in patients who had undergone unilateral herniorrhaphy. Another weakness was that few patients had a regional anesthesia, which may have affected our apnea rate, although a recent meta-analysis showed no difference in regional vs general anesthesia in former preterm infants undergoing herniorrhaphy [20]. Finally, reasons for the prolonged intubation in infants undergoing repair before NICU discharge were not clearly documented and we were not able to determine the true apnea rate in this subset of patients.…”

Anestesia neuroaxial comparada à anestesia geral para procedimentos na metade inferior do corpo: revisão sistemática de revisões sistemáticas

“…Only 27 systematic reviews were read in full text, but 9 were excluded because they were not compatible with the inclusion criterion, and 8 were published in more than one journal or cited more than once in databases. This process left us with 10 systematic reviews for qualitative analysis [8][9][10][11][12][13][14][15][16][17] . Kappa statistics for screening systematic reviews was 0.82.…”