Abstract
Introduction: Inguinal hernia is a more frequent problem in male infants with an increased incidence in twin ones. Prematurity is considered as a risk factor. During open surgery of hernia under general anesthesia, there is a high incidence of apnea especially in the preterm infants. Caudal anesthesia could been a more effective approach for induction of anesthesia and analgesia. Case presentation: Here, we presented three two-months-old infants (3.5-3.9 kg) for inguinal hernia repair, simultaneously who were born at 35 weeks’ gestation al age. They were undergone bilateral inguinal hernia repair with single shot awake caudal anaesthesia. Conclusion: Although herrniorraphy is a common procedure in preterm infants, the induction of simultaneous caudal anesthesia for this procedure is rare event. On the other hand, the complications of anestethic techniques such as apnea are important.Indeed, triple infants with based same genetic background didn’t show any undesirable events after anaesthesia.
Highlights
INTRODUCTIONThe repair of inguinal hernia has been remained as the most common procedure in pediatric surgery
Inguinal hernia is a more frequent problem in male infants with an increased incidence in twin ones
During open surgery of hernia under general anesthesia, there is a high incidence of apnea especially in the preterm infants
Summary
The repair of inguinal hernia has been remained as the most common procedure in pediatric surgery. We present three two-months-old siblings undergoing surgery for inguinal hernia repair by successful awake caudal block Their weight were 3500, 3600 and3900 grams, respectively. There is potential complications from postoperative apnea and direct brain toxicity from anaesthetic drugs superimposed upon pre existing altered brain development in preterm infants This necessitate the examination of neurodevelopmental outcomes in the context of large randomised controlled trials of general, compared with regional, anesthesia, in former preterm infants undergoing for inguinal hernia repair. A male 39 postconceptual weeks old infant, was administered a caudal anesthesia by 5 mg/kg lidocaine , 2.5 mg/kg bupivacaine and 1.25 μg/kg clonidine without sedation for bilateral inguinal hernia repair, which had early postoperative apnea.
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