High-dose caffeine suppresses postoperative apnea in former preterm infants

Thirty-two former preterm infants (less than or equal to 44 weeks postconceptual age) undergoing inguinal hernia repair were prospectively studied. General inhalational anesthesia with neuromuscular blockade was used. No barbiturates or opioids were given. Infants were randomly divided into two grou...

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Bibliographic Details
Published in:Anesthesiology (Philadelphia) 1989-09, Vol.71 (3), p.347-349
Main Authors: WELBORN, L. G, HANNALLAH, R. S, FINK, R, RUTTIMANN, U. E, HICKS, J. M
Format: Article
Language:English
Subjects:
Anesthesia, General
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Apnea - epidemiology
Apnea - prevention & control
Biological and medical sciences
Bradycardia - epidemiology
Bradycardia - prevention & control
Caffeine - administration & dosage
Clinical Trials as Topic
Double-Blind Method
Emergency and intensive care: neonates and children. Prematurity. Sudden death
Hernia, Inguinal - surgery
Humans
Infant
Infant, Newborn
Infant, Premature
Intensive care medicine
Medical sciences
Monitoring, Physiologic
Postoperative Complications - epidemiology
Postoperative Complications - prevention & control
Prospective Studies
Random Allocation
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Summary:Thirty-two former preterm infants (less than or equal to 44 weeks postconceptual age) undergoing inguinal hernia repair were prospectively studied. General inhalational anesthesia with neuromuscular blockade was used. No barbiturates or opioids were given. Infants were randomly divided into two groups. Group 1 received iv caffeine 10 mg/kg immediately after induction of anesthesia. Group 2 received iv saline. Respiratory pattern, heart rate, and SpO2 were monitored using an impedance pneumograph and a pulse oximeter, respectively, for at least 12 h postoperatively. Tracings were analyzed for evidence of apnea, periodic breathing, and/or bradycardia by a pulmonologist unaware of the drug given. None of the patients who received caffeine developed postoperative bradycardia, prolonged apnea, or periodic breathing, and none had postoperative SpO2 less than 90%. In the control group 13 (81%) developed prolonged apnea 4-6 h postoperatively. Fifty percent of the patients had SpO2 less than 90% at the time. This study shows that iv caffeine 10 mg/kg is effective in the control of apnea in otherwise healthy expremature infants between 37 and 44 weeks of postconceptual age. It is still recommended, however, that all infants at risk be monitored for at least 12 h for apnea and bradycardia following general anesthesia.
ISSN:0003-3022
1528-1175
DOI:10.1097/00000542-198909000-00005