Anaesthesia and analgesia

Abstract

The administration of safe and effective anaesthesia is paramount to successful paediatric surgery. Paediatric anaesthesia has seen many advances over the past seven decades and is now a recognised sub-speciality. This chapter examines the key components of anaesthesia in the paediatric population including the importance of pre-operative care, including investigations, premedication, and parental presence. The chapter discusses the core equipment and medications used in the induction, maintenance, and emergence of anaesthesia. Advances in intraoperative and post-operative monitoring of neonates, infants and older children are reviewed, emphasizing their key role in improving patient safety. Issues of significant importance to the paediatric population such as fluid management, temperature control and day-case surgery are highlighted. Surgical procedures that pose specific anaesthetic challenges are analysed individually. Adequate analgesia in the post-operative period is paramount to patient well-being and parent satisfaction. This objective is best achieved using a multimodal analgesic model. The key pillars of which are explained including recent advances in regional anaesthesia.