Association of anesthesia type with prolonged postoperative intubation in neonates undergoing inguinal hernia repair

J Perinatol. 2021 Mar;41(3):571-576. doi: 10.1038/s41372-020-0703-4. Epub 2020 Jun 4.

Abstract

Purpose: The purpose of this study is to determine factors associated with prolonged intubation after inguinal herniorrhaphy in neonates.

Methods: Retrospective, single institution review of neonates undergoing inguinal herniorrhaphy between 2010 and 2018. Variables recorded included demographics, comorbidities, ventilation status at time of hernia repair, and anesthetic technique.

Results: We identified 97 neonates (median corrected gestational age 39.9 weeks, IQR 6.6). The majority (87.6%) received general anesthesia (GA); the remainder received caudal anesthesia (CA). Among the GA subjects, 25.8% remained intubated for at least 6 h after surgery, whereas none of the CA patients required intubation postoperatively (p = 0.03). Two risk factors associated with prolonged postoperative intubation: a history of intubation before surgery (p = 0.04) and a diagnosis of bronchopulmonary dysplasia (p = 0.03).

Conclusions: Neonates undergoing inguinal herniorrhaphy under GA have a greater rate of prolonged postoperative intubation compared with those undergoing CA. A history of previous intubation and bronchopulmonary dysplasia were significant risk factors for prolonged postoperative intubation.