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An Overview of Pediatric Anesthesia

  • Craig SimsEmail author
  • Tanya Farrell
Chapter

Abstract

Anesthesia in children is very safe. However, critical events do occur, with more than half of them involving the respiratory system and the airway. To maintain safety, surgery and anesthesia for children can only be performed in centers with the correct staff training, equipment and physical environment. Professional organizations have guidelines for these requirements. The law gives parents the right to decide about a child’s treatment, but consent and the right to refuse treatment becomes more complicated as the child’s age increases towards 16–18 years and the child is more likely to have Gillick competency. Although there is overlap between the anesthetic techniques used in adults and children, the techniques used in adults are not always appropriate in children—for example, IV induction is not always best, and the technique for adult rapid sequence induction requires modification to prevent complications in children. Children will not always keep their hand still for an IV insertion, and will not always simply accept a facemask. Techniques to assist with these common tasks are used in pediatric practice. After anesthesia, children are more likely than adults to wake unhappy and upset, and will not always suffer pain quietly. Emergence delirium is a common problem and can spoil an otherwise good anesthetic experience for the family. There are several effective strategies to prevent it.

Keywords

Safety of pediatric anesthesia Emergence delirium Inhalational induction Day surgery in children Post extubation stridor Pediatric anesthesia services 

Further Reading

Anesthesia Risk and Provision of Services

  1. ANZCA Guideline PS29 Statement on anaesthesia care of children in healthcare facilities without dedicated paediatric facilities. http://www.anzca.edu.au/resources/professional-documents. Accessed Feb 2019.
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Preoperative Assessment

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Consent

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IV Access

  1. Haile D, Suominen PK. Technologies in pediatric vascular access: have we improved the success rate in peripheral vein cannulation? Acta Anesthesiol Scand. 2017;61:710–3.CrossRefGoogle Scholar
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Induction and Aspiration

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Recovery

  1. ANZCA Guideline PS4. Recommendations for the post-anaesthesia recovery room. 2006. http://www.anzca.edu.au/resources/professional-documents. Accessed Feb 2019.
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  3. Martin S, et al. Guidelines on the prevention of post-operative nausea and vomiting in children. Association Paediatric Anaesthetists Great Britain & Ireland; 2016. www.apagbi.org.uk.

DVT Prophylaxis

  1. Gordan RJ, Lombard FW. Perioperative venous thrombembolism: a review. Anesth Analg. 2017;125:403–12. An adult-focused review which is contemporary and comprehensive.CrossRefGoogle Scholar
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Awareness

  1. Malviya S, et al. The incidence of intraoperative awareness in children: childhood awareness and recall evaluation. Anesth Analg. 2009;109:1421–7.CrossRefGoogle Scholar

Vaccination During Anesthesia

  1. Currie J, et al. The timing of vaccination with respect to anaesthesia and surgery. Association of Paediatric Anaesthetists of Great Britain and Ireland. https://www.apagbi.org.uk/sites/default/files/inline-files/Final%20Immunisation%20apa.pdf. Accessed July 2019.
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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Anaesthesia and Pain ManagementPerth Children’s HospitalNedlandsAustralia

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