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Pediatric Surgery International

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01-10-2014 | Original Article

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

Authors: A. Lambertz, G. Schälte, J. Winter, A. Röth, D. Busch, T. F. Ulmer, G. Steinau, U. P. Neumann, C. D. Klink

Published in: Pediatric Surgery International | Issue 10/2014

Abstract

Background

Inguinal hernia repair is the most frequently performed surgical procedure in infants and children. Especially in premature infants, prevalence reaches up to 30 % in coincidence with high rates of incarceration during the first year of life. These infants carry an increased risk of complications due to general anesthesia. Thus, spinal anesthesia is a topic of growing interest for this group of patients. We hypothesized that spinal anesthesia is a feasible and safe option for inguinal hernia repair in infants even at high risk and cases of incarceration.

Methods

Between 2003 and 2013, we operated 100 infants younger than 6 months with inguinal hernia. Clinical data were collected prospectively and retrospectively analyzed. Patients were divided into two groups depending on anesthesia procedure (spinal anesthesia, Group 1 vs. general anesthesia, Group 2).

Results

Spinal anesthesia was performed in 69 infants, and 31 infants were operated in general anesthesia, respectively. In 7 of these 31 infants, general anesthesia was chosen because of lumbar puncture failure. Infants operated in spinal anesthesia were significantly smaller (54 ± 4 vs. 57 ± 4 cm; p = 0.001), had a lower body weight (4,047 ± 1,002 vs. 5,327 ± 1,376 g; p < 0.001) and higher rate of prematurity (26 vs. 4 %; p = 0.017) compared to those operated in general anesthesia. No complications related to surgery or to anesthesia were found in both groups. The number of relevant preexisting diseases was higher in Group 1 (11 vs. 3 %; p = 0.54). Seven of eight emergent incarcerated hernia repairs were performed in spinal anesthesia (p = 0.429).

Conclusions

Spinal anesthesia is a feasible and safe option for inguinal hernia repair in infants, especially in high-risk premature infants and in cases of hernia incarceration.

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Title: Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases
Authors: A. Lambertz
G. Schälte
J. Winter
A. Röth
D. Busch
T. F. Ulmer
G. Steinau
U. P. Neumann
C. D. Klink
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 10/2014
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-014-3590-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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