METHODS OF ANAESTHESIA:

All babies and young children generally require GA. This may be supplemented by RA a local anaesthesia (LA) infiltration of the wound.

As a general rule, all infants less than 1 year of age should be intubated & have assisted ventilation for all but the briefest of procedures. Occasionally, for very short procedures this age limit may be decreased to 3-6 months

Young babies have a high metabolic rate and become rapidly cyanosed, if the airway is compromised or if laryngoscopy is lengthy.

Induction: It may be carried out in the induction room for ASA 1-2 patients. Parents may be present for patients 8 months and above if child is anxious. They should not be present for neonates or infants less than 6 months of age or patients who have unstable CVS parameters or those in whom problems are anticipated during induction. Parental presence in these instances may prove to be a hindrance and a hazard.

VOLUME OF FLUID REPLACEMENT

Maintenance fluid

Blood loss: Acceptable blood loss will be in the range of 10-20% circulating blood volume depending on the rate of loss and the preoperative hematocrit. If blood is replaced with crystalloid (Hartmann's solution), it should be with 3 times the estimated loss. Colloids may be used in the ratio of 1:1.