Anesthesia and analgesia in children

Abstract

Most children undergoing orthopaedic surgery are healthy with no intercurrent disease to complicate anesthesia. A few have significant cardiac, respiratory, or neuromuscular diseases. Local anesthetic techniques alone, without general anesthesia, are used much less often than in adult orthopaedic patients and are usually most suitable for those patients whose intercurrent disease makes general anesthesia particularly dangerous. A light general anesthetic is often supplemented by local anesthesia. This reduces the requirement for anesthetic agents and opioids during surgery and allows children to experience a rapid, pain-free recovery from operation. For most children and their families, particularly those who need multiple procedures, the main problems associated with anesthesia are pre-operative anxiety and poorly treated post-operative pain. Attention to these and, of course, the anesthetic itself is essential for the well-being of children with orthopaedic problems. © Springer-Verlag London Limited 2010.