ESRA Academy. Martins A. Sep 8, 2016; 138339; 0174 Topic: Paediatric Population
Ana Martins
Ana Martins

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Background and Aims:

In order to reduce the risk of postoperative apnoea, awake spinal or awake caudal anaesthesia are recommended for hernia surgery in newborn babies and preterm with postconceptional age <60weeks .

When light general anaesthesia with anaesthetic agents such as sevoflurane is combined with a spinal or a caudal block, postoperative apnoea is very rare. The aim of this study was to evaluate the safety and effectiveness of this approach.


Retrospective study in 31 infants undergoing inguinal hernia surgery from 2013 to 2015. Data was collected from surgical records and electronic process. General anaesthesia with a face mask with no opiate nor neuromuscular blocking agents was applied, maintaining the infant’s spontaneous breathing and combined with a caudal or spinal block. Anaesthesia procedure, patient comfort, and perioperative complications were registered.


Total of 31 infants with postconceptional age less than 60 weeks (16 were prematures) that were submited to inguinal hernia surgery. 27 were male (87,1%), aging between 1 and 7 months. 18 were classified as ASA I (58,1%).

Caudal block was performed in 17 patients.

All blocks were successful. The patients were maintained only with sevoflurane during the procedure. No complications were seen. There were no register of postoperative apnoea. 


The technique proposed is an effective alternative to general and awake loco-regional anaesthesia. Our results support the use of general anaesthesia with sevoflurane combined with spinal ou caudal block in children with postconcepcional age less than 60 weeks  undergoing hernia surgery, while it provides excellent conditions for surgery and reduces risk of postoperative apnoea.

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