High-dose Caffeine Suppresses Postoperative Apnea in Former Preterm Infants

Publisher Website
Google Scholar
Abstract
Thirty-two former preterm infants (.ltoreq. 44 weeks postconceptual age) undergoing inguinal hernia repair were prospectively studied. General inhalation anesthesia with neuromuscular blockade was used. No barbiturates or opioids were given. Infants were randomly divided into two groups. Group 1 received iv caffeine 10 mg/kg immediately after induction of anesthesia. Group 2 received iv saline. Respiratory pattern, heart rate, and SpO2 were monitored using an impedance pneumograph and a pulse oximeter, respectively, for at least 12 h postoperatively. Tracings were analyzed for evidence of apnea, periodic breathing, and/or bradycardia by a pulmonologist unaware of the drug given. None of the patients who reveived caffeine developed postoperative bardycardia, prolonged apnea, or periodic breathing, and none had postoperative Spo2 less than 90%. In the control group 13 (81%) developed prolonged apnea 4-6 h postoperatively. Fifty percent of the patients had Spo2 less than 90% at the time. This study shows that iv caffeine 10 mg/kg is effective in the control of apnea in otherwise healthy expremature infants between 37 and 44 weeks of postconceptual age. It is still recommended, however, that all infants at risk be monitored for at least 12 h for apnea and bradycardia following general anesthesia.