Key result
Awake caudal anesthesia without sedation is linked to ~94% less severe intraoperative hypotension vs combined anesthesia.
Why the study?
Intraoperative blood pressure affects postoperative outcomes in infants, but whether the type of anesthesia impacts intraoperative blood pressure management in very low birth weight infants was unknown.
Does awake caudal anesthesia without sedation prevent critical blood pressure drops compared to caudal block with general anesthesia in very low birthweight infants undergoing inguinal hernia repair?
Population
42 very low birthweight infants scheduled for open inguinal hernia repair
Comparison
Awake caudal anesthesia without sedation vs caudal block combined with general anesthesia
Design
Retrospective study
Authors
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May support awake caudal anesthesia to limit hypotension in very low birthweight infants; hypothesis-generating and requires randomized confirmation.
Cohort (n=42)
No
Does awake caudal anesthesia without sedation prevent critical blood pressure drops compared to caudal block with general anesthesia in very low birthweight infants undergoing inguinal hernia repair?
Absolute Event Rate: 3% vs 47%
p-value: p=<0.001
Awake caudal anesthesia without sedation significantly reduces the incidence and duration of critical intraoperative hypotension compared to combined general and caudal anesthesia in very low birthweight infants.
Fideler et al. (2020) conducted a cohort in Inguinal hernia in very low birthweight infants (n=42). Awake caudal anesthesia without sedation vs. Caudal block in combination with general anesthesia was evaluated on Measured mean arterial blood pressure values below 35 mmHg (p=<0.001). Awake caudal anesthesia without sedation significantly reduced the incidence of intraoperative mean arterial blood pressure values below 35 mmHg compared to combined general and caudal anesthesia (3% vs 47%, p<0.001).
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