Early Forays Into Using Spinal Anesthesia for Inguinal Hernia Surgery in Preterm Infants: A Retrospective Analysis...

Area of Science:

• Anesthesiology
• Neonatal Surgery
• Pediatric Surgery

Background:

• Neonates, especially preterm infants, face increased risks of inguinal hernia and cardiopulmonary complications with general anesthesia.
• Spinal anesthesia has been the preferred method for neonatal inguinal hernia repair at our institution for over 20 years.

Purpose of the Study:

• To evaluate the safety and efficacy of spinal anesthesia for inguinal hernia repair in neonates.
• To analyze outcomes in term and preterm infants, including those with postconceptional age below 50 weeks.

Main Methods:

• Retrospective review of 19 neonates undergoing inguinal surgery with spinal anesthesia over a 6-year period.
• Spinal block administered using a 26G needle with 0.2 mL/kg of 0.5% heavy bupivacaine.
• Inclusion of neonates with varying gestational ages (27-38 weeks) and birth weights (740-3300 g).

Main Results:

• No patients required respiratory or inotropic support during or after surgery.
• No instances of apnea were observed, including in four neonates with bronchopulmonary dysplasia.
• All procedures were completed successfully under spinal anesthesia without conversion to general anesthesia.

Conclusions:

• Neonatal spinal anesthesia is a safe and efficient technique for inguinal hernia repair.
• This method eliminates the need for NICU admission or escalated respiratory care, even in neonates with bronchopulmonary dysplasia.