Pediatric Anesthesia: Techniques and Risk Reduction

Abstract

Anesthesia is used for a number of invasive procedures in children. The anesthetic technique chosen for each child must be tailored to the nature of the surgical procedure, the patient, and the needs of the surgeon. Clearly, not all children can be managed the same way. One must take great care to understand each child's background as well as the surgical problem facing them. In terms of anesthetic management specifically, there are certain guidelines that can be followed to prevent complications from occurring or to be able to deal with the complications that may arise in a systematic and thoughtful way. The intention of the following brief chapter is to review basic anesthetic techniques used in children, the anatomic and physiologic differences encountered with various age groups, and the care and consideration necessary to prevent complications from occurring when delivering anesthetic care to children. (Murray-Torres et al.2021)
The use of anesthesia for the treatment of children is a common occurrence. Most general anesthetics produce states indistinguishable from normal sleep and allow for safe and humane surgical techniques. Activity and exploratory behavior are normal human developmental events that naturally decline over time, secondary to maturation of the central nervous system. Individual sensitivity to general anesthetics varies greatly. Prudence dictates starting the anesthetic slowly, measuring the child's threshold of response to the nearly chosen dose of anesthetic, and then either continuing to raise the dose to produce an anesthetic level of response or modifying the technique chosen. When an anesthetic state is attained, steady-state levels of anesthetic concentration should usually be maintained throughout the procedure. Examiner activity continues undiminished but may be less predictable in nature. Abuse of general anesthesia may cause injury to the mother and/or child. Overall, anesthetic techniques currently available for use with children offer approximately similar degrees of safety and predictable outcomes.