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10 - Intravenous induction versus inhalation induction for general anaesthesia in paediatrics

Published online by Cambridge University Press:  13 August 2009

By
Teresa Hardcastle
Edited by
Brian Smith ,
Paul Rawling ,
Paul Wicker  and
Chris Jones
Brian Smith
Affiliation:
Edge Hill College of Higher Education, Liverpool
Paul Rawling
Affiliation:
Edge Hill College of Higher Education, Liverpool
Paul Wicker
Affiliation:
Edge Hill College of Higher Education, Liverpool
Chris Jones
Affiliation:
Edge Hill College of Higher Education, Liverpool
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Summary

Key learning points

  • Preferred techniques

  • The use of premedication

  • Intravenous induction techniques

  • Induction agents used

  • Inhalational induction techniques

  • Inhalational agents used in anaesthesia of paediatric patients

The two methods for induction of general anaesthesia are intravenous and inhalational. Intravenous is more frequently used than inhalational induction in adults whereas in paediatric anaesthesia both intravenous and inhalational induction techniques are widely used.

Paediatric anaesthesia is a challenging speciality in itself. Children are not small adults. The spectrum of diseases they suffer from is different from adults and their responses to disease and injury may differ both physically and psychologically. The differences in the anatomy and physiology of neonates, infants and children have important consequences in many aspects of anaesthesia (Aitkenhead et al., 2003). According to Mellor (2004) the technical difficulties that are associated with small size together with the child's psychological and developmental understanding may prove more challenging for induction of anaesthesia in the child compared with the adult. The special demands of inducing anaesthesia in children necessitate the unique skills of the anaesthesia team. One of the many challenges for the anaesthesia team is to minimise distress for the child at induction of anaesthesia (Holm-Knudsen et al., 1998).

According to Messeri et al. (2004) the induction of anaesthesia for surgery is a stressful time for both child and family. Donnelly (2005) argues that a young child's emotional development is immature and that the presence of a parent or carer will provide reassurance to maintain the child's sense of security.

Type
Chapter
Information
Core Topics in Operating Department Practice
Anaesthesia and Critical Care
 , pp. 102 - 109
Publisher: Cambridge University Press
Print publication year: 2007

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References

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