Abstract
Anaesthesia is annually administered in approximately 100 thousand paediatric patients. Anaesthetic procedures for individual types of medical examinations and surgery appropriate for children's age are elaborated.
More complicated medical acts are concentrated into several centres. Administration of quality and safe anaesthesia to a paediatric patient requires respecting many physiological and pharmacological differences of the paediatric age group.
Indication of anaesthesia, particularly in children aged up to four years needs to be considered responsibly. The cause is a risk of neurotoxicity of some anaesthetics, which based on the results of animal experiments, lies in uncoordinated apoptosis of maturing neurons, disorder of neural network formation and myelinisation of axons.
Retrospective and currently also prospective observational studies aim to explain the side effects of anaesthetics on child's brain. There are no direct proofs of damaging child's brain by anaesthetics so far; despite the fact it is recommended to apply anaesthetic procedu res with minimum potential neurotoxicity (sevoflurane, regional analgesia, opiates) and to avoid all adverse effects that could deepen neurotoxicity.
It is rightful to claim that possible psychological and physical damage of a child by a medical act without anaesthesia is far more serious than toxic effects of anaesthetics. Complete information on neurotoxicity of anaesthetics on child's brain at www.smarttots. org