Epidurals, Ethics, and Expectations: Talking Risks and Benefits in Obstetric Anesthesia
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Question of the Day
A 42-week postconceptual age, former preterm neonate receives general anesthesia for an inguinal herniorrhaphy. This neonate should be hospitalized for 24 hours after surgery because of an increased risk for which of the following?
Question of the Day
A 42-week postconceptual age, former preterm neonate receives general anesthesia for an inguinal herniorrhaphy. This neonate should be hospitalized for 24 hours after surgery because of an increased risk for which of the following?
Your Answer
Correct Answer
Explanation
There is a high incidence of central postoperative apnea in former preterm infants who present for surgery. Apnea most commonly develops in patients younger than 46 weeks postconceptual age (PCA); however, apnea has been reported up to 60 weeks PCA. Anemia (hematocrit <30%) is a potent, independent risk factor associated with apnea in former preterm infants. Routine, preoperative assessment for anemia should be performed in former premature infants because the risk for apnea in anemic former preterm infants is not altered by postconceptual or gestational age.
References:
Apnea of Prematurity and Postoperative Apnea Coté CJ, Zaslavsky A, Downes JJ, et al. Postoperative apnea in former preterm infants after inguinal herniorrhaphy. A combined analysis. Anesthesiology. 1995;82(4):809-822. Kurth CD, Spitzer AR, Broennle AM, Downes JJ. Postoperative apnea in preterm infants. Anesthesiology. 1987;66(4):483-488. Pediatric Obstructive Sleep ApneaOA Series: October 2025
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OA-SOAP Fellows Webinar Series
Epidurals, Ethics, and Expectations: Talking Risks and Benefits in Obstetric Anesthesia
