Anaesthesia and Associated Diseases:Considerations for Newborns

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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ANESTHESIA AND ASSOCIATED DISEASES

Related topics

Anaesthesia General Principles

Pre term Infant

Downs Syndrome

Cystic Fibrosis and Plastic Surgery

Cleft lip and Palate And Cystic Hygroma

Burns and Neurology

Ophthalmology

Dental Surgery and ENT

Hematological Disorders

Dr Sunita Goel
Lecturer in Anaesthesiology
BJ Wadia Childrens hospital

Considerations for the newborn :

Prophylaxis against hemorrhage: Ensure that Vitamin K is given, to prevent hemorrhage due to lack of Vit-K dependant factors.
Temperature: Avoid cold stress and decreases in body temperature.
- A heated transport incubator should be used to transfer the neonate to and from the operating room.
- The operating room must be warmed to at least 24 degree C
- Leave the infant in the incubator till all the preparations are complete.
- Humidify anesthetic gases using the heated humidifier.
- Ensure that warm skin prep solutions (40 C) are used and that excess solutions are dried from the skin.
- Cover the head to prevent excessive heat loss from the scalp.
Airway :
- It is preferable to intubate the neonate awake.
- Use a tube that passes the glottis easily and allows a slight leak during positive pressure ventilation.
- Use sterile ETT.
- Position the tube carefully. Remember that in term newborn the trachea is only 4 cm long; therefore pass the tube 2cm
  below the vocal cords for optimal positioning.
- Check the air entry to all areas of the lung.
Anesthesia circuit:
- The J.R. modification of the T- piece is mostly suitable for the newborn.
- Manual control of ventilation is preferable for thoraco-abdominal surgery, as subtle changes in compliance can be detected
  rapidly and adjustments can be made to maintain ventilation.

Next : Anaesthesia in Pre term Infant

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