Laparoscopic versus Open Inguinal Hernia Repair Is Feasible in Infants with Caudal Anesthesia and Spontaneous Respiration

Author:

Kiblawi Rim1ORCID,Beck Christiane2,Keil Oliver3ORCID,Schukfeh Nagoud1,Hofmann Alejandro Daniel1,Ure Benno Manfred1,Kuebler Joachim Friedrich1

Affiliation:

1. Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany

2. Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Niedersachsen, Germany

3. Clinic for Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Niedersachsen, Germany

Abstract

Abstract Introduction Minimally invasive surgery (i.e., laparoscopy) and minimally invasive anesthesia (i.e., caudal anesthesia with spontaneous respiration) have separately shown benefits for inguinal hernia repair in infants, yet to what degree these techniques can be combined remains unknown. This study investigated whether laparoscopy impacts the feasibility of performing caudal anesthesia with spontaneous respiration in infants. Methods Prospectively collected data of all infants less than 12 months old and over 3 kg weight who underwent laparoscopic indirect hernia repair (LAP) at our department from 2019 to 2021 were compared with a historical control-matched group of infants who underwent open repair (OPEN) from 2017 to 2021. We assessed the patients' characteristics, anesthesia, and surgical data as well as intra- and postoperative complications. Results A total of 87 infants were included (LAP n = 29, OPEN n = 58). Caudal anesthesia with spontaneous respiration was feasible in 62.1% of cases (LAP n = 55.2%, OPEN n = 65.5%; nonsignificant). Neither group registered anesthetic intra- or postoperative complications. Sedatives were utilized in 97% of LAP patients versus 56.9% of OPEN patients (p < 0.00001). The airway was secured with a laryngeal mask in 89.7% of patients during LAP versus 41.4% during OPEN (p < 0.00001). No significant differences were found regarding the use frequency of opioids (48.3% LAP vs. 34.5% OPEN; nonsignificant) or neuromuscular blockers (6.9% LAP vs. 5.2% OPEN; nonsignificant). Conclusion This is the first comparative study on caudal anesthesia and spontaneous respiration in infants undergoing laparoscopic versus open inguinal hernia surgery. Laparoscopy increased the need for ventilatory support and sedatives but did not significantly impair the feasibility of caudal anesthesia and spontaneous respiration.

Publisher

Georg Thieme Verlag KG

Subject

Surgery,Pediatrics, Perinatology and Child Health

Reference43 articles.

1. Choice of repairing inguinal hernia in children: open versus laparoscopy;V Raveenthiran;Indian J Pediatr,2017

2. Laparoscopic versus open inguinal hernia repair in pediatric patients: a systematic review;C Esposito;J Laparoendosc Adv Surg Tech A,2014

3. Laparoscopic versus open inguinal hernia repair in children ≤ 3: a randomized controlled trial;C D Gause;Pediatr Surg Int,2017

4. Laparoscopic pediatric inguinal hernia repair: a controlled randomized study;M Abd-Alrazek;J Pediatr Surg,2017

5. Regional (spinal, epidural, caudal) versus general anaesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy;L J Jones;Cochrane Database Syst Rev,2015

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