From the Department of Pediatric Anesthesiology, Health Sciences Centre, Winnipeg, Manitoba, Canada.
Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
A A Pract. 2020 Jul;14(9):e01251. doi: 10.1213/XAA.0000000000001251.
We report a series of 20 neonates and infants (18 born preterm) who underwent laparoscopic inguinal hernia repair with caudal anesthesia, oxygen via nasal cannula, and intravenous anesthesia. Surgery was successful in all cases without airway instrumentation or intraoperative complications. Sedation was provided with dexmedetomidine, propofol, and remifentanil. Two patients had apnea in the following 24 hours. There were no unplanned intensive care admissions. Laparoscopy allowed unplanned bilateral repair in 2 cases. Caudal with intravenous anesthesia without airway instrumentation is a viable technique for laparoscopic inguinal hernia repair. Avoiding general endotracheal anesthesia may reduce perioperative complications and influence postoperative disposition.
我们报告了一系列 20 例新生儿和婴儿（18 例早产儿）的病例，他们在尾侧麻醉、经鼻导管给氧和静脉麻醉下接受了腹腔镜腹股沟疝修补术。所有手术均成功完成，无需气道器械或术中并发症。镇静采用右美托咪定、异丙酚和瑞芬太尼。2 例患者在接下来的 24 小时内出现呼吸暂停。无计划的重症监护病房收治。腹腔镜允许 2 例计划外双侧修复。无需气道器械的尾侧与静脉麻醉相结合是腹腔镜腹股沟疝修补术的可行技术。避免全身气管内麻醉可能会减少围手术期并发症并影响术后处置。
