% IMPORTANT: The following is UTF-8 encoded. This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.
@PHDTHESIS{Fischer:61176,
author = {Fischer, Robert},
othercontributors = {Rossaint, Rolf},
title = {{N}arkosekomplikationen im {S}äuglingsalter : eine
retrospektive {V}ergleichsstudie zwischen
{I}ntubationsnarkose und {S}pinalanästhesie an
{S}äuglingen mit {L}eistenhernienoperationen unter
besonderer {B}erücksichtigung postoperativer {A}pnoephasen},
address = {Aachen},
publisher = {Publikationsserver der RWTH Aachen University},
reportid = {RWTH-CONV-122856},
pages = {77 S. : Ill., graph. Darst.},
year = {2006},
note = {Aachen, Techn. Hochsch., Diss., 2006},
abstract = {Subject of this study was to compare general anaesthesia
and spinal anaesthesia in infants. Anaesthetic complications
and postoperative apnea were discovered and subsequently
compared refer to the anaesthetic technique. For that
purpose the patient records of all infants undergoing
inguinal hernia repair at University Hospital Aachen between
1997 and 2003 were collected and examined retrospectively.
Altogether 275 infants could be included in this study of
which 166 received general anaesthesia (ITN group) and 109
received spinal anaesthesia (SPA group). For general
anaesthesia muscle relaxants were used at introduction,
volatile anaesthetics were used for maintenance in $95\%$
(including $65\%$ Sevofluran) and for intraoperativ
analgesia opioid (Fentanyl, Piritramid) was used in 2/3 of
the patients. For spinal anaesthesia only isobaric
Bupivacaine $0.5\%$ in dosage 1 mg/kg (body weight minus
$10\%)$ was injected. The comparisons of pre-existing
conditions of the infants refer to the chosen anaesthetic
technique showed significant statistical differences: The
infants in SPA group had a lower birth weight and have been
born in earlier pregnancy, at operation the postmenstrual
age and body weight was lower; also a higher grade of
comorbidity was demonstrated. For summary the infants in SPA
group had already preoperative a higher disposition to
develop perioperative complications or postoperative apnea.
Postoperative apnea was detected by respiration monitors
and/or monitoring of peripheral oxygen saturation.
Intraoperative anaesthetic complications was analysed
separately from apnea complications: Within the ITN group
$16.9\%$ of the infants demonstrated intraoperative
anaesthetic complications whereas in SPA group none was
described (p=0.000). Postoperative new occurred apnea was
demonstrated by 14 infants of ITN group and one infant of
SPA group (p=0.020). The analysis of subgroups (infants
after postpartal respirator-therapy (n=66), infants with
pulmonal diseases (n=73), ex-premature infants (n=142),
infants with less than 1500g birth weight (n=67)) showed
significant advantages for the use of spinal anaesthesia.
Critical analysis of already published studies concerning
anaesthetic complications and postoperative apnea in infants
demonstrates great variability but in all more complications
and higher incidence of postoperative apnea in general
anaesthesia. The risk of anaesthetic complications or
postoperative apnea is lower in spinal anaesthesia compared
to general anaesthesia, but even after spinal anaesthesia
postoperative apnea can occur, which is important concerning
ambulatory surgery and postoperative monitoring. For
conclusion this study shows that spinal anaesthesia can be
recommended as a save and effective anaesthetic technique
especially in high-risk infants with pre-existing diseases.},
cin = {510000-1},
ddc = {610},
cid = {$I:(DE-82)510000-1_20140620$},
typ = {PUB:(DE-HGF)11},
urn = {urn:nbn:de:hbz:82-opus-15169},
url = {https://publications.rwth-aachen.de/record/61176},
}
guest ::