Mohajerani Seyed Amir, Roodneshin Fatemeh
Department of Anesthesiology, Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tanaffos. 2014;13(3):31-7.
Retinopathy of prematurity (ROP) is the most common reason behind surgical procedures in premature newborns. Anesthesia in these patients is life-threatening due to post-operative apnea of prematurity (POA). This study aimed to determine the predisposing factors to POA in premature infants and to explore the role of prophylactic aminophylline in decreasing the incidence of POA.
Fifty patients with prematurity who were candidates for elective eye surgery (less than one hour) were selected and received aminophylline (3 mg/kg) 5 minutes after the induction of anesthesia with sevoflurane. Patients were kept in the recovery room for 2 hours post-operation in an incubator and were monitored for SPO2, apnea, bradycardia and other signs of desaturation and apnea.
There were no statistically significant differences in the gestational age and weight, sex, postconceptual age and weight and other demographic characteristics between the experimental and control groups. Gestational age<28 weeks, postconceptual age<60 weeks, birth weight, operation weight and anemia (OR=1.91; 95% CI: 1.24-3.73; P=0.012) were the predisposing factors associated with postoperative apnea. Treatment with aminophylline as compared with the placebo was associated with a significantly decreased risk of post-operative apnea (OR=0.53; 95% CI 0.28-0.98; P=0.034).
Aminophylline can be used prophylactically to decrease the risk of postoperative apnea with no major adverse effects.
早产儿视网膜病变（ROP）是早产新生儿进行外科手术的最常见原因。由于早产术后呼吸暂停（POA），这些患者的麻醉具有生命危险。本研究旨在确定早产儿发生POA的易感因素，并探讨预防性使用氨茶碱在降低POA发生率中的作用。
选择50例准备进行择期眼科手术（手术时间小于1小时）的早产儿，在七氟醚诱导麻醉5分钟后给予氨茶碱（3mg/kg）。术后将患者置于暖箱中在恢复室观察2小时，监测其血氧饱和度（SPO2）、呼吸暂停、心动过缓及其他去饱和与呼吸暂停征象。
试验组和对照组在胎龄、体重、性别、孕龄、体重及其他人口统计学特征方面无统计学显著差异。胎龄<28周、孕龄<60周、出生体重、手术时体重及贫血（OR=1.91；95%CI：1.24 - 3.73；P=0.012）是与术后呼吸暂停相关的易感因素。与安慰剂相比，氨茶碱治疗可使术后呼吸暂停风险显著降低（OR=0.53；95%CI 0.28 - 0.98；P=0.034）。
氨茶碱可预防性用于降低术后呼吸暂停风险，且无重大不良反应。
