Advantages of Caudal Anesthesia for Premie Hernia Repair: An Evidence- Based Debate

The goal of anesthesia for the expremature infant having hernia repair is to provide a safe anesthetic that will minimize intraand postoperative cardiorespiratory complications and have minimal long lasting effects on the developing infant. General (GA) and regional anesthesia, spinal anesthesia (SA) and caudal anesthesia (CA) are options well described in the anesthesia literature. The choice of anesthetic for these patients should be based on prospective safety, efficacy and economic data but is often based on a practitioner’s passion toward a technique rather than scientific evidence. My practice is to use single dose CA, with SA in the event of a failed caudal block.