Observation & Monitoring of Neonates Post-anesthesia
Caffeine for Neonates

Observation & Monitoring  of Neonates Post-anesthesia
Kovarik- May 2006

Definitions:
Premature: baby born before 37 weeks post gestational age
Term: baby born at or beyond 37 weeks gestation
Anesthesia: any sedative, anxiolytic, or narcotic administered to facilitate a procedure or exam and any spinal, epidural, caudal, or significant regional block.
Apnea: respiratory pause greater than 15 seconds or accompanied by cyanosis or desaturation.
Bradycardia: slowing of the heart rate to under 60 beats per minute.

Guidelines for Observation/Monitoring
All prematures under 52 weeks gestation receiving anesthesia will be observed and monitored for apnea/bradycardia for a minimum of 12 hours following completion of the procedure or the last observed apnea/bradycardia episode.

All term infants under one month of age receiving anesthesia will be observed and monitored for apnea/bradycardia for a minimum of 4 hours following completion of the procedure, if apnea/bradycardia occurs during this observation period the baby will be observed for a minimum of 12 hours.

All children under 6 months of age receiving anesthesia will be observed and monitored for apnea/bradycardia for a minimum of 2 hours following completion of the procedure and if apnea/bradycardia occurs during this observation period the baby will be observed for a minimum of 12 hours.

 

Caffeine for Neonates
Kovarik June 2006

Indications: Neonates born at less than 37 weeks post-gestation and currently less than 52 weeks gestation undergoing general anesthesia and plan to monitor with pulse oximetry (minimum) for 12 hours (minimum).

Contraindications: Allergy, hx of tachyarrhythmia. 

Dosing: Caffeine Citrate Inj (20mg/cc) 10 mg/kg IVP administered following induction of anesthesia. (Clearance half-life 6 hours)