Thirty-two former preterm infants (less than or equal to 44 weeks postconceptual age) undergoing
inguinal hernia repair were prospectively studied. General inhalational
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 received
caffeine developed postoperative
bradycardia, 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.