283 POST-OPERATIVE APNEA AND BRADYCARDIA IN FORMER PREMATURE INFANTS

Abstract

Apnea in the immediate post-operative period is often observed in young former premature infants. In order to characterize post-operative apnea in this population, 30 infants were evaluated prospectively with pre-operative and recovery room pneumocardiograms for a minimum of two hours. Episodes of apnea and bradycardia were also recorded by nuring staff. Mean birthweight ± SEM was 1900 ± 142 g and mean G.A. ± SEM was 32±0.6 wks. Apnea was defined as cessation of breathing of 15 seconds or longer, or less than 15 seconds accompanied by bradycardia (> 40 bpm below resting heart rate). Fourteen of 30 (46.7%) infants had post-operative apnea not diagnosed prior to surgery. Two infants (6.6%) had apnea with no discerable change pre- and post-operatively. The remaining 14 (46.7%) had no post-operative apnea. Factors placing these infants at greatest risk were post-conceptional age 32-55 weeks (p<.05) and postnatal age of 4-25 weeks (p <.05). The apnea was central in origin in all cases. The last post-operative apneic episode occurred in 11 (78.5%) infants within 24 hours of surgery, while 2 (14.3%) infants had apneic episodes more than 24 hours after surgery. One patient (7.2%) required continuous intubation and ventilatory support following surgery. These data suggest former premature infants undergoing surgery should be carefully monitored during the post-operative period, and the use of day surgery in these infants may place them at high risk for significant apnea-related complications.

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