Journal article

Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair Data from the General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes

Geoff Frawley, Graham Bell, Nicola Disma, Davinia E Withington, Jurgen C de Graaff, Neil S Morton, Mary Ellen McCann, Sarah J Arnup, Oliver Bagshaw, Andrea Wolfler, David Bellinger, Andrew J Davidson

Anesthesiology | LIPPINCOTT WILLIAMS & WILKINS | Published : 2015


BACKGROUND: Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes. The General Anesthesia compared to Spinal anesthesia study compares neurodevelopmental outcomes after awake RA or GA in otherwise healthy infants. The aim of the study is to describe success and failure rates of RA and report factors associated with failure. METHODS: This was a nested cohort study within a prospective, randomized, controlled, observer-blind, equivalence trial. Seven hundred twen..

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Awarded by National Institute for Health Research


Funding Acknowledgements

All hospitals and centers were generously supported by the anesthesiology departmental funding. In addition to this funding, specific grants received for this study are as follows: Australia and New Zealand: The Australian National Health and Medical Research Council, Canberra, Australian Capital Territory, Australia; Australian and New Zealand College of Anesthetists, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia. This study was supported by the Victorian Government's Operational Infrastructure Support Program in Melbourne, Victoria, Australia; Department of Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Anaesthesia, Monash Medical Centre, Melbourne, Victoria, Australia; Department of Anaesthesia and Pain Management, Princess Margaret Hospital for Children, Perth, Western Australia, Australia; Department of Paediatric Anaesthesia, Women's Children's Hospital, Adelaide, South Australia, Australia; and Department of Paediatric Anaesthesia and Operating Rooms, Starship Children's Hospital, Auckland, New Zealand. United States: National Institutes of Health, Bethesda, Maryland; Food and Drug Administration, Silver Spring, Maryland; Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Anesthesia and Pain Medicine, Seattle Children's Hospital, Seattle, Washington; Department of Anesthesiology, Children's Hospital Colorado, Denver, Colorado; Department of Anesthesia, University of Iowa Hospital, Iowa City, Iowa; Department of Anesthesiology, Children's Medical Center Dallas, Dallas, Texas; Department of Pediatric Anesthesiology, Anne and Robert H. Lurie Children's Memorial Hospital, Chicago, Illinois; Department of Anesthesiology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire; Department of Pediatric Anesthesia, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Anesthesia and Pediatrics, The University of Vermont/ Fletcher Allen Health Care, Burlington, Vermont. Italy: Italian Ministry of Health, Rome, Italy; Department of Anesthesia, Istituto Giannina Gaslini, Genoa, Italy; Department of Anesthesiology and Paediatric Intensive Care, Ospedale Vittore Buzzi, Milan, Italy; and Department of Anaesthesia, Ospedale Papa Giovanni XXIII, Bergamo, Italy. The Netherlands: Fonds NutsOhra, Amsterdam, The Netherlands; Department of Anesthesiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; and Department of Anesthesiology, University Medical Center Groningen, Groningen, The Netherlands. Canada: Canadian Institute of Health Research, Ottawa, Ontario, Canada; Canadian Anesthesiologists' Society, Toronto, Ontario, Canada; Pfizer Canada Inc., Kirkland, Quebec, Canada; Department of Anesthesia, Montreal Children's Hospital, Montreal, Quebec, Canada; and Departement d'Anesthesie, CHU Sainte-Justine, Montreal, Quebec, Canada. United Kingdom: Health Technologies Assessment-National Institutes for Health Research United Kingdom, Southampton, United Kingdom.Anesthesiology Departmental Funding: Department of Anaesthesia, Royal Hospital for Sick Children, Glasgow, United Kingdom; Department of Anaesthesia, Birmingham Children's Hospital, Birmingham, United Kingdom; Anaesthetic Department, Sheffield Children's Hospital, Sheffield, United Kingdom; Department of Paediatric Anaesthesia, Bristol Royal Hospital for Children, Bristol, United Kingdom; Department of Anaesthetics, Royal Belfast Hospital for Sick Children, Belfast, United Kingdom; and Department of Anaesthesia, Pain Relief, and Sedation, Alder Hey Childrens' NHS Foundation Trust, Liverpool, United Kingdom.