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Pharmacology of Anesthetic Agents in Children

  • Craig SimsEmail author
  • John Thompson
Chapter

Abstract

Several factors determine the dose of drugs in children, but size and age are the most important. Size is most commonly dealt with by weight-based dosing, although surface area is used for some drugs. Young age causes pharmacokinetic and pharmacodynamic differences from adults. Pharmacokinetic changes are due to many factors, but the most important are differences in body composition and immature metabolic pathways. These changes are greatest in neonates, who require smaller doses based on weight than older children. Infants may require larger doses based on weight than all other age groups. Although the metabolism of most drugs is reduced at young ages, suxamethonium, remifentanil and atracurium are exceptions, because their metabolic enzymes are fully active at birth. Sevoflurane is by far the most commonly used volatile agent, and is the only agent available in most countries for inhalational induction. Propofol is an important anesthetic agent in children. It suppresses airway reflexes, reduces emergence delirium and reduces nausea and vomiting. However many drugs, including propofol, are not licensed for all ages and all purposes in children.

Keywords

Pharmacokinetics Children Pharmacodynamic changes Children Pharmacology Neonates Drug clearance Children Pediatric drug doses Pediatric anesthetic drugs 

Further Reading

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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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