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The current view of paediatric anaesthesia

Publication at Second Faculty of Medicine |
2012

Abstract

There are approximately 100.000 anaesthesias yearly given to children's patients in the Czech Republic. The indication can be both surgical and nonsurgical (diagnostic).

The number of radical surgeries and surgeries that the youngest age group (newborns and premature babies) concern increases constantly. The preoperative examination complies with the seriousness of surgery.

By the elective surgeries up to the medium extent there is only a paediatric examination necessary. The introduction chapters summarize both the physiological and pharmacological differences which are connected with children's patients and their effect on the planned anaesthesia.

The preoperative fasting takes only 2 hours (pure liquids) or 4 hours (breastfeeding). The premedication includes a sedative component (midazolam).

The anaesthesia is usually inducted by giving anaesthetic agent via inhalation (small children) or via intravenous administration (older children). The most common drugs administrated during an anaesthesia by children are sevofluran (inhalated), cisatracurium and rocuronium (nondepolarising muscle relaxants), sufentanil, morphine (opiates) and levobupivacain (local anaesthetic) too.

The anaesthesia is either complemented or combined with some epidural technique which are more often used. A successful anaesthesia depends on an experienced anaesthetist, medical devices, medicine and tools complied with the patient age and an appropriate postoperative care as well.

The number of complications and potential long-term consequences of repeated anaesthesias is then insignificant.