College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Department of Anaesthesia and Pain Management, Flinders Medical Centre, Adelaide, South Australia, Australia.
Paediatr Anaesth. 2023 Oct;33(10):793-799. doi: 10.1111/pan.14726. Epub 2023 Jul 14.
Inguinal hernia surgery is one of the most common electively performed surgeries in infants. The common nature of inguinal hernia combined with the high-risk population involving a predominance of preterm infants makes this a particular area of interest for those concerned with their perioperative care. Despite a large volume of literature in the area of infant inguinal hernia surgery, there remains much debate amongst anesthetists, surgeons and neonatologists regarding the optimal perioperative management of these patients. The questions asked by clinicians include; when should the surgery occur, how should the surgery be performed (open or laparoscopic), how should the anesthesia be conducted, including regional versus general anesthesia and airway devices used, and what impact does anesthesia choice have on the developing brain? There is a paucity of evidence in the literature on the concerns, priorities or goals of the parents or caregivers but clearly their opinions do and should matter. In this article we review the current clinical surgical and anesthesia practice and evidence for infants undergoing inguinal hernia surgery to help clinicians answer these questions.
腹股沟疝手术是婴儿最常见的择期手术之一。腹股沟疝的常见性加上涉及早产儿为主的高风险人群，使得这一领域成为关注围手术期护理的人们特别感兴趣的领域。尽管在婴儿腹股沟疝手术领域有大量文献，但麻醉师、外科医生和新生儿科医生在这些患者的最佳围手术期管理方面仍存在许多争议。临床医生提出的问题包括：手术应何时进行，手术应如何进行（开放或腹腔镜），麻醉应如何进行，包括区域麻醉与全身麻醉以及使用的气道装置，麻醉选择对发育中的大脑有何影响？文献中关于父母或照顾者的关注点、优先事项或目标的证据很少，但显然他们的意见很重要，也应该受到重视。在本文中，我们回顾了婴儿接受腹股沟疝手术的当前临床手术和麻醉实践及证据，以帮助临床医生回答这些问题。
