Current Practices and Priorities of Anesthetists and Consumers for Infants Undergoing Inguinal Hernia Surgery

There is a paucity of data on the chosen anesthesia management for infant inguinal hernia surgery. We aimed to characterize self-reported anesthetic practice in Australia and New Zealand. We also aimed to identify the outcomes that matter to both anesthetists and to parents and carers.

Two separate surveys were administered, one for anesthetists and the other for parents and carers of infants who had undergone an inguinal hernia operation.

Eighty-nine surveys were completed by anesthetists. The most common preferred anesthetic technique was general anesthesia for both preterm 55 (61.8%) and term infants 79 (91%). Anesthetists reported that an infant's gestational age at birth and health factors influence their choice of anesthetic, as well as their personal and institutional experience. The highest priority of anesthetists was "avoiding intraoperative critical events." Eighty-three surveys were completed by parents or carers. 48 (57.8%) reported their infant born preterm, and 50 (62.7%) spent time in the neonatal intensive care unit. The highest ranked priority for parents was "minimising impact on baby's brain."

The most common anesthetic type reported by parents and anesthetists for both preterm and term infants undergoing inguinal hernia surgery in Australia and New Zealand is general anesthesia. Many anesthetists do not feel confident in performing neuraxial blocks in infants; however, regional techniques are more likely to be preferred for preterm infants. In this study, anesthetists' top-ranked priority was avoiding intraoperative critical events, and parents and carers' top-ranked priority was minimizing impact on their baby's brain. Differences in the priorities of anesthetists and consumers indicate the need to ensure clinicians discuss issues relevant to parents in preoperative counseling. The need to involve consumers in future research directions and study design is highlighted. Data on anesthetic outcomes following hernia surgery in an Australian and New Zealand context are needed.