{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:20:11Z","timestamp":1779916811467,"version":"3.53.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Thoracic epidural anesthesia for open infantile hypertrophic pyloric stenosis surgery is a controversial issue in the presence of little comparative data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare this approach to general anesthesia for desaturation events (\u226490% oxygen saturation) and absolute values of minimal oxygen saturation, minimal heart frequency, operating\u2010room occupancy time, and durations of surgery in a retrospective study design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were retrieved for patients with infantile hypertrophic pyloric stenosis managed by thoracic epidurals under sedation or general anesthesia with rapid sequence induction between 01\/2007 and 12\/2017. Oxygen saturation and heart rate were analyzed over eight 5\u2010minutes intervals relative to the start of anesthesia \/ sedation (four\u2010time intervals) and before discharge of the patient from the operating room (four\u2010time intervals). Fisher's exact tests and mixed model two\u2010way analysis of variance for repeated measures were employed for intergroup comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The epidural and general anesthesia groups included 69 and 32 evaluable infants, respectively. Patients managed under epidural anesthesia had cumulatively higher minimimal mean (SD) oxygen saturation values (98.2 [2.6] % versus 96.6 [5.2] %, <jats:italic>p<\/jats:italic>\u00a0&lt; 0.001) and lower minimal mean (SD) heart rate values (127.9 [15.0] beats per minute versus 140.7 [17.2] beats per minute, <jats:italic>p<\/jats:italic>\u00a0&lt; 0.001) over time. Similarly, the frequency of desaturation events (defined as \u226490% oxygen saturation) was significantly lower for these patients during the period of 5\u00a0minutes after induction of sedation or general anesthesia (odds ratio 7.4 [2.1\u201325.9]; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) and during the subsequent period of five minutes (odds ratio 6.2 [1.1\u201333.9]; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.031). One case of prolonged respiratory weaning was observed in the general anesthesia group. The mean (SD) operating\u2010room occupancy was 61.9 (16.6) minutes for the epidural anesthesia group versus 73.3 (22.2) minutes for the general anesthesia group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.005) as a result of shorter emergence from sedation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In our series, maintaining spontaneous breathing with minimal airway manipulation in patients undergoing open repair of hypertrophic pyloric stenosis under single\u2010shot epidural anesthesia resulted in fewer desaturation events \u226490% than general anesthesia. In addition, this approach seems to result in shorter turnover times in the operating room.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14114","type":"journal-article","created":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T04:22:03Z","timestamp":1608956523000},"page":"452-460","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Epidural versus general anesthesia for open pyloromyotomy in infants: A retrospective observational study"],"prefix":"10.1111","volume":"31","author":[{"given":"Philipp","family":"Opfermann","sequence":"first","affiliation":[{"name":"Department of Anesthesia General Intensive Care Medicine and Pain Therapy Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caspar","family":"Wiener","sequence":"additional","affiliation":[{"name":"Department of Surgery Clinical Division of Pediatric Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8868-5942","authenticated-orcid":false,"given":"Werner","family":"Schmid","sequence":"additional","affiliation":[{"name":"Department of Anesthesia General Intensive Care Medicine and Pain Therapy Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Zadrazil","sequence":"additional","affiliation":[{"name":"Department of Anesthesia General Intensive Care Medicine and Pain Therapy Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Metzelder","sequence":"additional","affiliation":[{"name":"Department of Surgery Clinical Division of Pediatric Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Kimberger","sequence":"additional","affiliation":[{"name":"Department of Anesthesia General Intensive Care Medicine and Pain Therapy Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1647-3780","authenticated-orcid":false,"given":"Peter","family":"Marhofer","sequence":"additional","affiliation":[{"name":"Department of Anesthesia General Intensive Care Medicine and Pain Therapy Medical University of Vienna Vienna Austria"},{"name":"Department of Anesthesia and Intensive Care Medicine Orthopedic Hospital Speising Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1995.02170230077011"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.01.039"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.159.6.520"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03452.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004344"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2007.02194.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2003.00972.x"},{"issue":"4","key":"e_1_2_9_9_1","first-page":"153","article-title":"Caudal epidural anesthesia in pyloromyotomy in infants: our experience","volume":"13","author":"Busto Aguirreurreta N","year":"2000","journal-title":"Cir Pediatr"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2002.00855.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2011.03556.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03503.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/ael121"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2017.10.022"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12207"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003542"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1983.03330370053031"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13761"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2007.02230.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12543"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13710"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2000.00460.x"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13134"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2004.01240.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2004.01550.x"},{"issue":"2","key":"e_1_2_9_26_1","first-page":"211","article-title":"The European Society of Regional Anaesthesia and Pain Therapy\/American Society of regional anesthesia and pain medicine recommendations on local anesthetics and adjuvants dosage in Pediatric Regional Anesthesia","volume":"43","author":"Suresh S","year":"2018","journal-title":"Reg Anesth Pain Med"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12972"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12792"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14114","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pan.14114","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T02:19:49Z","timestamp":1693361989000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.14114"}},"subtitle":[],"editor":[{"given":"Francis","family":"Veyckemans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,1,29]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1111\/pan.14114"],"URL":"https:\/\/doi.org\/10.1111\/pan.14114","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,29]]},"assertion":[{"value":"2020-05-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}