Anesthesia for the expremature patient

Rendering anesthetic care to the expremature patient, particularly those born severely premature (<30 weeks’ gestation), poses unique challenges. These patients often suffer life-long sequelae of their prematurity, the severity of which depends on the type and extent of their morbidities of prematurity. Chronic lung disease (CLD), persistent apnea, and neurodevelopmental disabilities complicate the care of these patients. The expremature patient most commonly requires anesthesia for inguinal hernia repair, magnetic resonance imaging, stoma closure after surgery for necrotizing enterocolitis (NEC), vitrectomy for retinopathy of prematurity (ROP), and musculoskeletal procedures due to cerebral palsy (CP). The anesthesiologist must be aware of the propensity for reactive airway disease, vulnerability to upper respiratory infections (URI), and apnea and bradycardia following general anesthesia in those less than 60 weeks’ postconceptual age (PCA).