Tobias J D, Burd R S, Helikson M A
Department of Child Health, University of Missouri, Columbia 65212, USA.
Can J Anaesth. 1998 Oct;45(10):985-9. doi: 10.1007/BF03012306.
To report the occurrence of apnea and bradycardia in two former pre-term infants who received spinal anaesthesia without inhalational or intravenous anaesthetic agents during inguinal herniorrhaphy.
Two former pre-term infants who had no recent history of apnea or bradycardia and who had been discharged from the hospital presented for anaesthetic care during inguinal herniorrhaphy. Spinal anaesthesia using 1 mg.kg-1 tetracaine in dextrose 10% was performed. A sensory level of T4-6 was obtained in both infants. Neither infant received intravenous, oral, or inhalational agents for sedation. Five to ten minutes after placement of the spinal block, the two infants had frequent episodes of apnea and bradycardia. No change in the sensory level of spinal anaesthesia was noted. The apnea and bradycardia continued for a variable time into the postoperative period. Caffeine benzoate 10 mg.kg-1 was administered to one infant. Other than the apnea and bradycardia, both infants had uncomplicated postoperative courses.
Apnea can occur when spinal anaesthesia is used as the sole anaesthetic technique in the former pre-term infant. Appropriate monitoring for such problems based on the infant's post-conceptual age is suggested.
报告两名前早产儿在腹股沟疝修补术中接受脊髓麻醉（未使用吸入或静脉麻醉剂）时发生呼吸暂停和心动过缓的情况。
两名前早产儿，近期无呼吸暂停或心动过缓病史，已出院，在腹股沟疝修补术期间接受麻醉护理。使用1mg.kg-1丁卡因加10%葡萄糖进行脊髓麻醉。两名婴儿均获得T4 - 6感觉平面。两名婴儿均未接受静脉、口服或吸入镇静剂。脊髓阻滞放置后5至10分钟，两名婴儿频繁出现呼吸暂停和心动过缓。脊髓麻醉的感觉平面无变化。呼吸暂停和心动过缓在术后持续了不同时间。给一名婴儿静脉注射了10mg.kg-1苯甲酸钠咖啡因。除呼吸暂停和心动过缓外，两名婴儿术后过程均无并发症。
在前早产儿中，当脊髓麻醉作为唯一麻醉技术时可发生呼吸暂停。建议根据婴儿的孕龄进行适当监测以发现此类问题。
