Apnoea in a former preterm infant after caudal bupivacaine with clonidine for inguinal herniorrhaphy.

Awake regional anaesthesia for inguinal hernia repair in former preterm infants is suggested to avoid life-threatening respiratory complications known to occur after general anaesthesia. Caudal anaesthesia is becoming a more popular technique for this purpose. To prolong duration of anaesthesia and to reduce postoperative need for analgesics in these infants, caudal clonidine has been considered useful. We report a former preterm infant, who had two awake caudal anaesthetics for herniotomy within 3 weeks. The first was uneventful with bupivacaine 0.25% at 35 weeks postconceptional age. At 38 weeks, the baby suffered form intra- and postoperative apnoeas after inadvertent administration of bupivacaine 0.125% plus clonidine.