The use of caffeine in the control of post-anesthetic apnea in former premature infants

Abstract

Premature infants undergoing general anesthesia within the first few months of life are prone to develop apnea and/or bradycardia in the postoperative period. The incidence of perioperative apneic episodes is inversely correlated with gestational age and weight. Methylxanthines have been widely used by neonatologists for the management of apnea of prematurity. Although therapeutic blood concentrations and pharmacokinetic profiles in premature infants have been established for both theophylline and caffeine, caffeine has the distinct advantage of being a more potent central nervous system and respiratory stimulant, and possesses fewer cardiac side effects than does theophylline. We designed a prospective, double blind, randomized study to examine the possible effectiveness of caffeine in the prevention of apnea following anesthesia and surgery in premature infants.