postoperative apnea among premature or anemic infants undergoing inguinal hernia repair

premature or anemic infants who undergoing hernia repair operation had more chance to have postoperative complications such as apnea as compared with full-term infants. the incidence of respiratory complications among noted infants is more than 30% and postoperative apnea was most common complication among them. in one study, investigators found that gestational and postconceptional age, the presence of continuing apnoeic episodes and anemia as main determinants of postoperative apnea. it seems that infant who did not receive iv anesthetics were experience less respiratory complications. in the other hand iv anesthetics had hepatic metabolism for elimination and immature liver in premature infants had not sufficient elimination capacity. study participants were 1047 neonates with post conceptual age (pca) lower than 60 weeks who had undergoing inguinal operation during study period. sevoflure gas mask was used for anesthesia induction and then in deep anesthesia situation, caudal anesthesia was prepared with 1cc/kg solution of bupivacaine 2% and neonates were managed with spontaneous breathing with sevoflurane gas mask or endotracheal tube until end of operation. in the present study, 916 (87.5%) male and 131 (12.5%) female neonates were included. mean of gestational age and pca among neonates were 36.62 ± 38.0 and 46.80 ± 45.60 weeks. totally, postoperative apnea did not occur among any of study participants.