Abstract
Study Objective: To determine the feasibility of continuous caudal anesthesia with 2-chloroprocaine in conscious former preterm infants undergoing inguinal hernia repair. Design: Prospective study. Setting: University-affiliated children's hospital. Patients: Ten former preterm infants, ASA physical status II and III, who were 35 to 49.5 weeks postconceptional age at the time of surgery. Interventions: Caudal anesthesia was administerd via an indwelling catheter using a loading dose of 1 mllkg (30 mglkg) of 3% 2-chloroprocaine, followed by incremental doses of 0.3 ml/kg (9 mg/kg) to achieve a level of T4 to T2. The block was maintained by a minimum infusion rate of 30 mg/kg/hr (1 mllkglhr) of the same local anesthetic solution. Measurements and Main Results: The mean cumulative dose of 2-chloroprocaine was 2.8 ± 1.0 mllkglhr (84 ± 30 mg/kg/hr) infused over a mean duration of 95 ± 35 minutes. Serum cholinesterase concentration and plasma 2-chloroprocaine concentration were measured in five infants. Conclusions: Three percent 2-chloroprocaine can be used effectively for continuous caudal anesthesia in conscious, former preterm infants for inguinal hernia and penoscrotal surgical procedures lasting 85 to 170 minutes.
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