麻醉类型与行腹股沟疝修补术的新生儿术后长时间插管的相关性。
Association of anesthesia type with prolonged postoperative intubation in neonates undergoing inguinal hernia repair.
机构信息
John R. Oishei Children's Hospital, Buffalo, NY, USA.
Great Lakes Anesthesiology, Buffalo, NY, USA.
出版信息
J Perinatol. 2021 Mar;41(3):571-576. doi: 10.1038/s41372-020-0703-4. Epub 2020 Jun 4.
PURPOSE
The purpose of this study is to determine factors associated with prolonged intubation after inguinal herniorrhaphy in neonates.
METHODS
Retrospective, single institution review of neonates undergoing inguinal herniorrhaphy between 2010 and 2018. Variables recorded included demographics, comorbidities, ventilation status at time of hernia repair, and anesthetic technique.
RESULTS
We identified 97 neonates (median corrected gestational age 39.9 weeks, IQR 6.6). The majority (87.6%) received general anesthesia (GA); the remainder received caudal anesthesia (CA). Among the GA subjects, 25.8% remained intubated for at least 6 h after surgery, whereas none of the CA patients required intubation postoperatively (p = 0.03). Two risk factors associated with prolonged postoperative intubation: a history of intubation before surgery (p = 0.04) and a diagnosis of bronchopulmonary dysplasia (p = 0.03).
CONCLUSIONS
Neonates undergoing inguinal herniorrhaphy under GA have a greater rate of prolonged postoperative intubation compared with those undergoing CA. A history of previous intubation and bronchopulmonary dysplasia were significant risk factors for prolonged postoperative intubation.
目的
本研究旨在确定与新生儿腹股沟疝修补术后长时间插管相关的因素。
方法
回顾性分析 2010 年至 2018 年间接受腹股沟疝修补术的新生儿。记录的变量包括人口统计学特征、合并症、疝修补时的通气状态和麻醉技术。
结果
我们确定了 97 名新生儿（中位校正胎龄 39.9 周，IQR 6.6）。大多数（87.6%）接受全身麻醉（GA）；其余接受骶管麻醉（CA）。在 GA 组中，25.8%的患者术后至少需要插管 6 小时，而 CA 组无一例患者需要术后插管（p=0.03）。与术后长时间插管相关的两个危险因素：术前有插管史（p=0.04）和支气管肺发育不良（p=0.03）。
结论
与接受 CA 的新生儿相比，接受 GA 行腹股沟疝修补术的新生儿术后长时间插管的发生率更高。既往插管史和支气管肺发育不良是术后长时间插管的显著危险因素。
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