Evidence map›Paper›PMID 39508417›Full record

Trial reportPaediatric anaesthesia2025

Caudal block, high flow oxygen insufflation and dexmedetomidine sedation for inguinal hernia surgery in infants-A prospective evaluation of an alternative anesthesia technique.

Fiona J Taverner, Laura L Burgoyne, Ross Scott-Weekly, Benjamin F van der Griend, Cheryl S L Chooi, Sanjeev Khurana, Susan R Humphreys, Shalem Lemaqz, Scott Morris, Claire T Roberts and 1 more

Abstract readClinical TrialMulticenter Study
In one paragraph

Trial report in Paediatric anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Fiona J TavernerFlinders University, College of Medicine and Public Health, Adelaide, South Australia, Australia.ORCID 0000-0003-4253-0643
Laura L BurgoyneDepartment of Children's Anaesthesia, Women's and Children's Hospital, North Adelaide, South Australia, Australia.ORCID 0000-0003-1088-1641
Ross Scott-WeeklyDepartment of Anaesthesia, Christchurch Hospital, Christchurch, New Zealand.ORCID 0000-0001-6547-853X
Benjamin F van der GriendDepartment of Anaesthesia, Christchurch Hospital, Christchurch, New Zealand.ORCID 0000-0001-8084-6302
Cheryl S L ChooiDepartment of Anaesthesia and Pain Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia.
Sanjeev KhuranaDepartment of Paediatric Surgery, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Susan R HumphreysThe University of Queensland, Brisbane, Queensland, Australia.ORCID 0000-0003-0286-2088
Shalem LemaqzFlinders University, College of Medicine and Public Health, Adelaide, South Australia, Australia.
Scott MorrisFlinders University, College of Medicine and Public Health, Adelaide, South Australia, Australia.
Claire T RobertsFlinders University, College of Medicine and Public Health, Adelaide, South Australia, Australia.
Britta S von Ungern-SternbergDepartment of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, Western Australia, Australia.ORCID 0000-0002-8043-8541

Funding

Australian and New Zealand College of AnaesthetistsAustralian Society of AnaesthetistsFlinders FoundationSociety for Paediatric Anaesthesia in New Zealand and AustraliaThe Hospital Research Foundation Group
6 · The paper itself

Abstract

backgroundInguinal hernia repair is the most common operation in infants, with well recognized anesthetic and perioperative risks. The aim was to investigate if the combination of caudal block, high-flow nasal oxygen insufflation and intravenous dexmedetomidine sedation is suitable for infants undergoing inguinal hernia surgery.

methodsA prospective multicenter international study was performed in three centers in Australia and New Zealand. Fifty infants less than 64 weeks post-menstrual age undergoing inguinal hernia surgery were enrolled. Exclusion criteria were any condition that contraindicated the use of the anesthesia technique. The technique included intravenous dexmedetomidine with a loading dose of 1-2 mcg/kg over 10 min and maintenance of 0.2-3 mcg/kg/h, high-flow nasal oxygen insufflation 2 L/kg/min with an oxygen blender, and a caudal block using 1 mL/kg 0.2% ropivacaine. The primary outcome was the successful completion of surgery without conversion to general anesthesia.

resultsCompletion of surgery with the technique was successful in 41/50 (82%) infants. Care was provided by 22 anesthesiologists and 11 surgeons. Infants had a low incidence of intraoperative complications, including apnea [1 (2.4%)], bradycardia [2 (4.9%)], hypotension [2 (4.9%)], and desaturation [1 (2.4%)]. Postoperative complications included apnea [3 (7.3%)], bradycardia [3 (7.3%)], hypotension [3 (7.3%)], desaturation [4 (9.8%)]. No infants were intubated in the first 24 h postoperatively.

conclusionCaudal block, high-flow nasal oxygen insufflation and intravenous dexmedetomidine sedation is a potential alternative to general anesthesia for infant inguinal hernia surgery with a low rate of complications in this small cohort of infants.

Indexed as

Anesthesia, CaudalDexmedetomidineHernia, InguinalHypnotics and SedativesFemaleHerniorrhaphyHumansInfantInfant, NewbornInsufflationMaleOxygenOxygen Inhalation TherapyProspective StudiesDexmedetomidineHypnotics and SedativesOxygencaudaldexmedetomidinehigh‐flowinfantinguinal hernia

Identifiers

PMID39508417
PMCPMC11701962

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.