3 Anaesthesia for infants and children with chronic respiratory system disorders

Abstract

Safe and effective anaesthetic management of the infant or child who suffers from a chronic respiratory system disorder requires that the anaesthesiologist understand: (1) the pathophysiology of the disorder; (2) the metabolism and pulmonary development associated with the child's age; (3) the child's general medical history; (4) the history and current status of the child's respiratory disorder; and (5) the potential interaction of the respiratory disorder itself and current drug therapy with anaesthetic agents, adjuvant drugs and techniques to be considered for the perioperative care of the child. A detailed history of the child's respiratory disorder as well as prior experience with anaesthesia and operations, combined with direct personal consultation with the child's primary care physician and pulmonary specialist, will help the anaesthesiologist minimize the hazards associated with anaesthesia in these children. Finally, the anaesthesiologist needs to be especially cautious in predicting for the surgeon and the family the duration and the levels of support needed for recovery following operation and anaesthesia. The anaesthesiologist should consider warning the family and the surgeon that recovery may be slower and more complex than in completely healthy children, and may call for special therapy for a time following anaesthesia.