Life-threatening Apnea in Infants Recovering from Anesthesia

Abstract

To determine whether prematurely born [human] infants with a history of idiopathic apneic episodes are more prone than other infants to life-threatening apnea during recovery from anesthesia, 214 infants (173 full term, 41 premature) who received anesthesia were studied. Fifteen premature infants had a preanesthetic history of idiopathic apnea. Six of these required mechanical ventilation because of idiopathic apneic episodes during emergence from anesthesia. Two were ventilated for other reasons, and 7 recovered normally. Infants ventilated for apnea were younger (postnatal age 1.6 .+-. 1.2 mo., mean .+-. SD; conceptual age 38.6 .+-. 3.0 wk) than those who recovered normally (postnatal age 5.6 .+-. 2.7 mo; conceptual age 55.1 .+-. 11.3 wk (P < 0.01). No other premature or full-term infant was ventilated because of postoperative apneic episodes. Apparently, anesthetics may unmask a defect in ventilatory control of prematurely born infants younger than 41-46 wk conceptual age who have a preanesthetic history of idiopathic apnea.