A Multi-site Randomized Controlled Trial Comparing Regional and General Anesthesia for Effects on Neurodevelopmental Outcome and Apnea in Infants

Inclusion Criteria: * Any infant scheduled for unilateral or bilateral inguinal hernia repair (with or without circumcision) * Any infant whose gestational age is 26 weeks or more (GA = 182 days) * Any infant whose post-menstrual age is up to 60 weeks (PMA = 426 days) Exclusion Criteria: * Any child older than 60 weeks post-menstrual age * Any child born less than 26 weeks gestation * Any contraindication to general or spinal/caudal anesthesia (for example: neuromuscular disorder or coagulopathy) * Pre-operative ventilation immediately prior to surgery * Congenital heart disease that has required ongoing pharmacotherapy * Known chromosomal abnormality or any other known acquired or congenital abnormalities (apart from prematurity) which are likely to affect development * Children where follow-up would be difficult for geographic or social reasons * Families where English is not the primary language spoken at home * Known neurological injury such as cystic periventricular leukomalacia (PVL), or grade 3 or 4 intra ventricular hemorrhage (ICH) (+/- post hemorrhage ventricular dilation) * Previous exposure to volatile anesthesia or benzodiazepines as a neonate or in the third trimester in utero.