Apnea in Preterm and Term Infants After Deep Sedation and General Anesthesia

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Abstract

OBJECTIVES: Determine the incidence of apnea in preterm and term infants after deep sedation (DS) compared with general anesthesia (GA).

METHODS: A retrospective chart review was performed on infants who underwent elective DS or GA from January 2008 to December 2013, were <60 weeks postmenstrual age if preterm or <50 weeks postmenstrual age if term, and were monitored for apnea as inpatients after DS or GA. Gestational age, postmenstrual age, chronologic age, anesthetic and sedative medications, procedure indication, and postsedation events were collected.

RESULTS: There were 61 DS encounters (24 preterm and 37 term) and 175 GA encounters (120 preterm and 55 term) that met inclusion criteria. No recorded apneic events in either preterm or term infants were recorded after DS. After GA, 1.7% of infants had apneic events (2.5% preterm and 0 term; P = .57 versus DS). All events occurred within 2 hours of monitoring in recovery.

CONCLUSIONS: None of the infants had apnea after DS. Rates from the literature would suggest that 2 to 6 of the preterm DS subjects should have experienced postsedation apnea. Sampled GA subjects had a rate of 2.5% in preterm infants exhibiting apnea after GA. Although the post-DS apnea rate is lower than what has been previously published, the small sample size and limitations of a retrospective design prevent us from directing a change in postsedation monitoring recommendations. However, we do support the need for prospective studies with strict monitoring criteria to reveal the true risk of post-DS apnea.

Original languageEnglish
Pages (from-to)314-320
Number of pages7
JournalHospital pediatrics
Volume8
Issue number6
DOIs
StatePublished - Jun 2018

Bibliographical note

Copyright © 2018 by the American Academy of Pediatrics.

Keywords

  • Anesthesia, General/adverse effects
  • Apnea/chemically induced
  • Bradycardia/chemically induced
  • Deep Sedation/adverse effects
  • Female
  • Humans
  • Hypnotics and Sedatives/administration & dosage
  • Incidence
  • Infant, Newborn
  • Infant, Premature
  • Male
  • Postoperative Period
  • Retrospective Studies
  • United States/epidemiology

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