ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

PEDIATRIC ANESTHESIA

Cansu Çiftci

Konya City Hospital, Faculty of Medicine, Department of Anesthesiology and Reanimation, Konya, Türkiye

Çiftci C. Pediatric Anesthesia. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.235-245.

ABSTRACT

  • Children under the age of three, particularly those born prematurely or with a recent history of upper respiratory tract infections, are at high risk for respiratory complications during anesthesia, necessitating thorough preoperative evaluation.
  • Preoperative fasting times should be adjusted based on the child’s age and medical condition to prevent hypoglycemia and dehydration while minimizing the risk of aspiration; the 6-4-1 rule offers advantages over the traditional 6-4-2 guideline.
  • Succinylcholine is primarily reserved for emergency rapid sequence intubation due to the associated risks of hyperkalemia and bradycardia, requiring close cardiac monitoring during administration.
  • Due to anatomical differences, pediatric airway management demands greater attention compared to adults; factors such as a relatively large tongue, a high larynx, and narrower airways increase the difficulty of intubation in infants.
  • Sevoflurane is the agent of choice for inhalational induction in pediatric anesthesia due to its minimal airway irritation and rapid onset, making it particularly suitable for facilitating the placement of a laryngeal mask airway.
  • Newborns are prone to rapid heat loss due to their large body surface area relative to mass; thus, active warming measures should be implemented intraoperatively, with careful monitoring of thermoregulation throughout the procedure.
  • In children recovering from upper respiratory tract infections, elective surgeries should be postponed for 2-4 weeks, as the risk of bronchospasm and laryngospasm remains elevated during this period.

Keywords: Anesthesia, pediatric; Airway management; Preoperative care; Respiratory complications; Thermoregulation; Sevoflurane; Postoperative nausea and vomiting; Fluid therapy.

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