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The aim of this study is to compare spinal and general anesthesia in neonates undergoing herniorrhaphy.
Spinal anesthesia (SA) is a fast, simple and cost-effective method that has been used for the performance of inguinal hernias since the beginning of the 20th century in adults.
One large observational study documented a low risk of post operative events with spinal anesthesia for inguinal hernia repair in infants . In addition, a randomized trial comparing reginal and general anesthesia in this population have not shown any significant differences in outcome. Spinal anesthesia reduces postoperative oxygen desaturation and respiratory morbidity when compared to general anesthesia (GA) in infants who underwent inguinal herniorrhaphy
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Spinal Anesthesia | Experimental | Oxygen supply will be done via nasal prong (2 L/min) when necessary. The local anesthetic used will be bupivacaine 0.6 mg/kg. |
|
| General Anesthesia | Active Comparator | Patients will receive sevoflurane for induction and maintenance in an air/oxygen mixture along. Endotracheal tube will be inserted. No opioids or nitrous oxide was used intraoperatively. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Spinal anesthesia | Diagnostic Test | Oxygen supply will be done via nasal prong (2 L/min) when necessary. The local anesthetic used will be bupivacaine 0.6 mg/kg. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | Heart rate will be recorded at post-anesthesia care unit. | Immediately postoperatively at post-anesthesia care unit |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | Heart rate will be recorded at baseline, every 10 min intraoperatively and every 30 min in post-anesthesia care unit. | Till two hours postoperatively |
| Mean arterial blood pressure | Mean arterial blood pressure will be recorded at baseline, every 10 min intraoperatively and every 30 min in post-anesthesia care unit. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mohammed S Elsharkawy, MD | Contact | 00201148207870 | mselsharkawy@med.tanta.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University Hospitals | Recruiting | Tanta | ElGharbia | 31527 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author
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| General anesthesia | Diagnostic Test | Patients will receive sevoflurane for induction and maintenance in an air/oxygen mixture along. Endotracheal tube will be inserted. No opioids or nitrous oxide was used intraoperatively. |
|
| Till two hours postoperatively |
| Incidence of bradycardia | Incidence of bradycardia will be measured, defined by decrease in basal heart rate by 20% and will be treated by I.V. atropine 0.02 mg/kg. | 24 hours postoperative |
| Incidence of hypotension | Hypotension will be assessed | 24 hours postoperative |
| Incidence of postoperative apnea | Apnea is defined as a pause in breathing for more than 15 s or more than 10 s if associated with oxygen saturation less than 80% or bradycardia (20% decrease in heart rate). Early apnea is defined as a priori as an apnea occurring within the first 30min postoperatively in the PACU, and late apnea is defined as an observed apnea occurring between 30 min and 12 hour postoperatively. | 24 hour postoperatively |
| The duration of surgery | The duration of surgery will be assessed from the start of surgery till the end of surgery. | Till the end of surgery |
| Need for postoperative O2 supplementation | Oxygen saturation will be recorded at baseline, every 10min intraoperatively and every 30 min in post-anesthesia care unit (PACU). | Till two hours postoperatively |
| Hospital stays | Hospital stays will be assessed from admission till discharge from hospital | 28 days postoperative |