CONTINUOUS CAUDAL ANESTHESIA FOR INGUINAL-HERNIA REPAIR IN FORMER PRETERM INFANTS

被引：47

作者：

HENDERSON, K ^{[1
]}

SETHNA, NF ^{[1
]}

BERDE, CB ^{[1
]}

机构：

[1] CHILDRENS HOSP MED CTR,DEPT ANESTHESIA,300 LONGWOOD AVE,BOSTON,MA 02115

来源：

JOURNAL OF CLINICAL ANESTHESIA | 1993年 / 5卷 / 02期

关键词：

ANESTHESIA; CAUDAL; CHOLINESTERASE; 2-CHLOROPROCAINE; INFANTS; PRETERM; INGUINAL HERNIA;

D O I：

10.1016/0952-8180(93)90140-A

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Study Objective: To determine the feasibility of continuous caudal anesthesia with 2-chloroprocaine in conscious former preterm infants undergoing inguinal hernia repair. Design: Prospective study. Setting: University-affiliated children's hospital. Patients: Ten former preterm infants, ASA physical status II and III, who were 35 to 49.5 weeks postconceptional age at the time of surgery. Interventions: Caudal anesthesia was administered via an indwelling catheter using a loading dose of 1 ml/kg (30 mg/kg) of 3% 2-chloroprocaine, followed by incremental doses of 0.3 ml/kg (9 mg/kg) to achieve a level of T4 to T2. The block was maintained by a minimum infusion rate of 30 mg/kg/hr (1 ml/kg/hr) of the same local anesthetic solution. Measurements and Main Results: The mean cumulative dose of 2-chloroprocaine was 2.8 +/- 1.0 ml/kg/hr (84 +/- 30 mg/kg/hr) infused over a mean duration of 95 +/- 35 minutes. Serum cholinesterase concentration and plasma 2-chloroprocaine concentration were measured in five infants. Conclusions: Three percent 2-chloroprocaine can be used effectively for continuous caudal anesthesia in conscious, former preterm infants for inguinal hernia and penoscrotal surgical procedures lasting 85 to 170 minutes.

引用

页码：129 / 133

页数：5

共 27 条

[1]

Kurth, Spitzer, Broennle, Downes, Postoperative apnea in preterm infants, Anesthesiology, 66, pp. 483-488, (1987)

[2]

Welborn, Rice, Hannallah, Broadman, Ruttimann, Fink, Postoperative apnea in former preterm infants: prospective comparison of spinal and general anesthesia, Anesthesiology, 72, pp. 838-842, (1990)

[3]

Dalens, Hasnaoui, Caudal anesthesia in pediatric surgery: success rate and adverse effects in 750 consecutive patients, Anesth Analg, 68, pp. 83-89, (1989)

[4]

Gunter, Watcha, Forestner, Et al., Caudal epidural anesthesia in conscious premature and high-risk infants, J Pediatr Surg, 26, pp. 9-14, (1991)

[5]

Spear, Deshpande, Maxwell, Caudal anesthesia in the awake, high-risk infant, Anesthesiology, 69, pp. 407-409, (1988)

[6]

Mazoit, Denson, Samii, Pharmacokinetics of bupivacaine following caudal anesthesia in infants, Anesthesiology, 68, pp. 387-391, (1988)

[7]

Berde, Convulsions associated with pediatric regional anesthesia, Anesth Analg, 75, pp. 164-166, (1992)

[8]

Kuhnert, Kuhnert, Reese, Measurement of 2chloroprocaine in plasma by selected ion monitoring, J Chromatogr, 224, pp. 488-491, (1981)

[9]

Report of the Second Task Force on Blood Pressure Control in Children–1987, Pediatrics, 79, pp. 1-25, (1987)

[10]

O'Brien, Abbey, Hinsvark, Perel, Finster, Metabolism and measurement of chloroprocaine, an ester-type local anesthetic, J Pharm Sci, 68, pp. 75-78, (1979)

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