{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T01:20:42Z","timestamp":1778635242373,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001136","name":"Australian and New Zealand College of Anaesthetists","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001136","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100022867","name":"Society for Paediatric Anaesthesia in New Zealand and Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022867","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001161","name":"Australian Society of Anaesthetists","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001161","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100022217","name":"Flinders Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009727","name":"Hospital Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009727","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Inguinal 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\u2010flow nasal oxygen insufflation and intravenous dexmedetomidine sedation is suitable for infants undergoing inguinal hernia surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective multicenter international study was performed in three centers in Australia and New Zealand. Fifty infants less than 64\u2009weeks post\u2010menstrual 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\u20132 mcg\/kg over 10\u2009min and maintenance of 0.2\u20133 mcg\/kg\/h, high\u2010flow nasal oxygen insufflation 2\u2009L\/kg\/min with an oxygen blender, and a caudal block using 1\u2009mL\/kg 0.2% ropivacaine. The primary outcome was the successful completion of surgery without conversion to general anesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Completion 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\u2009h postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Caudal block, high\u2010flow 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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.15040","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T12:28:10Z","timestamp":1730982490000},"page":"147-154","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Caudal block, high flow oxygen insufflation and dexmedetomidine sedation for inguinal hernia surgery in infants\u2014A prospective evaluation of an alternative anesthesia technique"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4253-0643","authenticated-orcid":false,"given":"Fiona J.","family":"Taverner","sequence":"first","affiliation":[{"name":"Flinders University, College of Medicine and Public Health  Adelaide South Australia Australia"},{"name":"Department of Anaesthesia and Pain Medicine Flinders Medical Centre  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1088-1641","authenticated-orcid":false,"given":"Laura L.","family":"Burgoyne","sequence":"additional","affiliation":[{"name":"Department of Children's Anaesthesia Women's and Children's Hospital  North Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6547-853X","authenticated-orcid":false,"given":"Ross","family":"Scott\u2010Weekly","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Christchurch Hospital  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8084-6302","authenticated-orcid":false,"given":"Benjamin F.","family":"van der Griend","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Christchurch Hospital  Christchurch New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheryl S. L.","family":"Chooi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Flinders Medical Centre  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev","family":"Khurana","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Women's and Children's Hospital  North Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0286-2088","authenticated-orcid":false,"given":"Susan R.","family":"Humphreys","sequence":"additional","affiliation":[{"name":"The University of Queensland  Brisbane Queensland Australia"},{"name":"Department of Anaesthesia and Pain Medicine Queensland Children's Hospital  South Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalem","family":"Leemaqz","sequence":"additional","affiliation":[{"name":"Flinders University, College of Medicine and Public Health  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Morris","sequence":"additional","affiliation":[{"name":"Flinders University, College of Medicine and Public Health  Adelaide South Australia Australia"},{"name":"Neonatal Unit Flinders Medical Centre  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire T.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Flinders University, College of Medicine and Public Health  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8043-8541","authenticated-orcid":false,"given":"Britta S.","family":"von Ungern\u2010Sternberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital  Perth Western Australia Australia"},{"name":"Perioperative Care 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