Pediatric anesthesia

Abstract

Before anesthesia's discovery, children were forcibly restrained during surgery. The introduction of ether in 1846 and chloroform in 1847 quickly led to their use in children. Most nineteenth century pediatric surgery treated minor ailments. The first giants initiating development of pediatric anesthesia, emerged in Canada, the US and the UK after World War I. Robson, the father of pediatric anesthesia, became Anaesthetist-in-Chief at Toronto's Hospital for Sick Children. He defined the major problems extant in pediatric anesthesia'and their solutions. Betty Lank, chief Nurse Anesthetist at Boston Children's Hospital, gave anesthesia for several surgical firsts. Robert Smith became head of pediatric anesthesia at Boston Children's Hospital in 1945, noting that Lank made me a pediatric anesthesiologist. In 1937, Ayre in the UK described his simple T-piece and in 1966, Jackson-Rees in the UK added an open-ended bag to Ayre's T-piece. The T-piece required high gas inflows, and thus, gradually gave way in the last half of the twentieth century to rebreathing anesthesia circuits with CO2 absorption. The US adopted rebreathing circuits early. In 1952, Deming showed that young children required more anesthesia than older patients, but as late as 1975, some surgeons might operate on infants (e.g., for PDA ligation) receiving little or no anesthesia, believing they felt no pain. In 1987, Redbook magazine put the lie to this belief and changed the practice.