This document provides an overview of pediatric anesthesia. It discusses: 1) The challenges of understanding and treating children due to their soft organs, immature systems, and sensitivity. Pain management requires careful planning. 2) Various anesthesia induction and maintenance techniques for children including inhaled anesthetics, intravenous agents, opioids, muscle relaxants and their reversal. 3) Airway management considerations like different laryngeal mask sizes for children of varying weights and the challenges of needles and intravenous access for children. 4) Fluid maintenance using Holliday-Segar formula and blood replacement guidelines based on child's age. Reversal and extubation procedures are also outlined.

1. For developing ambitions, we
need exposure to the world
Then only we can check, who resides in us!

2. What medication will save
the life?
.

3. Pain is a really strong
opponent; tackling him is
very difficult and needs
extraordinary planning
Nerve blocks
Epidural analgesia
Iv opioids
Multimodal analgesia

4. Who is willing and prepared for a try….. To
bell the cat?

5. Introduction to Paediatric
ANAESTHESIA
Dr Unnikrishnan P
M.D.,D.A.,P.D.C.C.[Neuroanaesthesia]
Asst. Professor
Dept of Anaesthesiology
Travancore Medical College,,
Kerala, India

6. Understanding a kid is very very
difficult
.

7. They come with a very Soft
heart!
.

8. Tender kidneys
.

9. A thief should always ensure the exit before
intruding into a house

10. Immature liver
If removal is difficult, install
carefully!

11. Damage prone respiratory
mechanics
Weak members make the whole
system weak!

12. Oh..! I hate cold O.T.s
.

13. My body is full of water!

14. Inhaled anaesthetics
Not so sweet; be careful
Halothane
Isoflurane
Sevoflurane
Desflurane

15. We tell the mother not to
give milk before anaesthesia,
but what we are going to
give…? Milk again!
.

16. Intravenous anaesthetic
agents
Thiopentone
Propofol
Ketamine
Etomidate

17. Others
Diazepam
Midazolam
Dexmedetomidine

18. Opioids
morphine
Meperidine or pethidine
Fentanyl
Alfentanil
Sufentanil
Remifentanil

19. Dont relax after giving
relaxants!
Succinyl choline
Pancuronium
Vecuronium
Atracurium
Rocuronium

20. Reversal agents
Neostigmine
Edrophonium

21. Are we comfortable about needles?
Then what about the child?
Fasting
Premedication
Child with URI
Child with full stomach
Difficult airway

22. Taking off….

23. Airway access and maintenance
.

24. Airway access and maintenance
y

25. LARYNGEAL MASK AIRWAY
[L.M.A.]
.
Size of LMA WEIGHT OF CHILD
1 ≤5 kg
1.5 5-10 kg
2 10-20 kg
2.5 20-30 kg
3 30-50 kg
4 50-70 kg
5 70-100 kg
6 >100 kg

26. Fluid maintenance
Holliday and Segar formula

27. Fluid maintenance
lactated Ringer's solution should be
used for all deficits and third-space
losses.
If a child is thought to be at risk for
hypoglycemia, 5% dextrose in 0.45%
normal saline should be
administered by “piggyback”
infusion at maintenance rates.
For most children, lactated Ringer's
solution is the only fluid required.

28. Blood replacement
.

29. Blood replacement
blood volume is approximately
100 to 120 mL/kg for a preterm
infant,
90 mL/kg for a full-term infant,
80 mL/kg for a child 3 to 12
months old,
and 70 mL/kg for a child older
than 1 year.

30. REVERSAL AND EXTUBATION
• .

31. REVERSAL AND EXTUBATION
• Lorem

32. .
• Visit me @ www.thelaymedicalman.blogspot.com
• www.facebook.com/groups/anaesthesiaindia/

33. THANK YOU!