CONTINUOUS CAUDAL ANESTHESIA FOR INGUINAL-HERNIA REPAIR IN FORMER PRETERM INFANTS

Study Objective: To determine the feasibility of continuous caudal ane sthesia with 2-chloroprocaine in conscious former preterm infants unde rgoing inguinal hernia repair. Design: Prospective study. Setting: Uni versity-affiliated children's hospital. Patients: Ten former preterm i nfants, ASA physical status II and III, who were 35 to 49.5 weeks post conceptional age at the time of surgery. Interventions: Caudal anesthe sia was administered via an indwelling catheter using a loading dose o f 1 ml/kg (30 mg/kg) of 3% 2-chloroprocaine, followed by incremental d oses of 0.3 ml/kg (9 mg/kg) to achieve a level of T4 to T2. The block was maintained by a minimum infusion rate of 30 mg/kg/hr (1 ml/kg/hr) of the same local anesthetic solution. Measurements and Main Results: The mean cumulative dose of 2-chloroprocaine was 2.8 +/- 1.0 ml/kg/hr (84 +/- 30 mg/kg/hr) infused over a mean duration of 95 +/- 35 minutes . Serum cholinesterase concentration and plasma 2-chloroprocaine conce ntration were measured in five infants. Conclusions: Three percent 2-c hloroprocaine can be used effectively for continuous caudal anesthesia in conscious, former preterm infants for inguinal hernia and penoscro tal surgical procedures lasting 85 to 170 minutes.