A pediatric anesthesiologist deals with issues of pain relief and maintaining the child’s health during surgical operations, invasive diagnostic and therapeutic procedures. His task is to ensure maximum physical and psychological comfort for the little patient throughout the entire procedure. Many parents are more frightened by the need for general anesthesia for children than by the intervention itself. Anesthesiologists have many modern methods of pain relief that are well tolerated, which makes it possible to find the optimal anesthesia option for each small patient.
Indications for the use of anesthesia
Pediatric specialists try to choose the most gentle procedures for children that do not require the administration of potent drugs. Unfortunately, this is not always possible. Under general anesthesia, children undergo:
- surgical operations;
- interventions with a high risk of bleeding;
- extensive therapeutic procedures in dentistry;
- operations on the abdominal organs;
- invasive diagnostic procedures.
The use of general anesthesia is indicated in cases where, for some reason, it is impossible to administer local anesthesia or place children under sedation.
The effect of anesthesia on the body
04.10.2021
For many, the term “anesthesia” has a frightening effect. This is understandable, since under anesthesia a person is deprived of the ability to control his actions. For this reason, a large number of myths and rumors are associated with anesthesia. Whether anesthesia is really so harmful to the body and what this harm consists of is to be clarified within the framework of this article.
What is anesthesia?
During anesthesia, the central nervous system is in a state of inhibition. The main task is to eliminate pain sensitivity. This is achieved by using drugs called anesthetics. In order to understand how anesthesia works, you need to have at least some understanding of the mechanism of pain.
The human body is literally permeated through and through with pain receptors. They are designed to absorb any irritation. A pain signal is transmitted to the receptor. It is then transmitted along a nerve fiber to the spinal cord . Already from it, information enters the brain , which is the main computer of the human body. by the brain and transmitted to organs and tissues in the form of pain. Under the influence of anesthesia, such a chain is broken. This blocks the transmission of pain impulses. Next we should consider the types of anesthesia.
Anesthesia and its types
“Narcosis” and “anesthesia” are not identical concepts. During anesthesia, consciousness is switched off (general anesthesia). During anesthesia, pain is eliminated with the help of anesthetics. You can interrupt impulses absolutely anywhere. Various types of anesthesia are based on this principle:
- Superficial anesthesia. This is achieved by using local anesthetics. In other words, impulse suppression occurs at the initial stage.
- Local anesthesia . The nerve through which pain impulses are transmitted is blocked. An anesthetic is injected into the place where the operation . Already in the initial part of the nerve, the pain impulse is interrupted.
- Conduction anesthesia. It is similar to local anesthesia. However, the nerve blockage does not occur at the site of the operation , but at any part of it. Let's say an operation is performed on the upper limb. In this case, the anesthetic can be injected into the collarbone area. When performing anesthesia of this type, the doctor must have high skill and precision. The needle should not hit the nerve. Otherwise it can be seriously damaged. But if the drug is administered at a considerable distance from the conductor, then the desired anesthesia may not be achieved.
- Epidural anesthesia. The nerve is blocked where it ends and enters the spinal cord . The area between the lining of the brain and the spinal canal is called the epidural space. This is where the anesthetic is injected.
- General anesthesia. All brain functions are depressed. Impulses enter it, but after processing there is no command about pain.
Of course, the safest type is considered to be superficial and local anesthesia. Conduction anesthesia poses a great danger. But this type is used only for surgical interventions on the extremities. In terms of danger, it is followed by epidural anesthesia. It is used for operations on the lower half of the body. The greatest risk is associated with general anesthesia.
Some common myths
anesthesiologist can say reliably how harmful anesthesia is . But most of them are still inclined to think that anesthesia is really harmful. However, this harm should not be correlated with common myths. Some people believe that after anesthesia you may not wake up. Of course, this is a misconception.
Before the operation , the anesthesiologist will carefully calculate the dose that is necessary for a particular patient. In case of an error, it will be detected by devices that monitor the patient during surgery . There is an opinion that anesthesia reduces life expectancy by at least 5 years. It is not known who came up with this, but no research has been carried out on this subject at all. With a smooth course of general anesthesia, the harm to the body will be minimal. But do not forget that any surgical intervention is a serious stress for the body.
Of course, there is a risk of not waking up after anesthesia. But statistics show that this is possible only in one case in a quarter of a million operations. At the same time, the mortality rate from car accidents is 1 in 10,000 accidents.
Some argue that after anesthesia, memory deteriorates and the intensity of thought processes decreases. This is partly true. But this can be observed mainly in elderly patients. They usually have vascular pathology of the brain . Anesthesiologists must take all these features into account.
Published in Surgery Premium Clinic
Main types of anesthesia for children during operations and invasive diagnostics
General anesthesia, depending on the type of drug administration into the body, can be divided into three large groups.
- Inhalation or mask anesthesia. It is carried out using inhalational anesthetics. Medicines in the form of an air mixture are supplied through a special mask. This type of anesthesia is used mainly for diagnostic procedures, dental procedures, and short surgical interventions.
- Intravenous anesthesia. It is performed by introducing the required dosage of the drug into the baby’s circulatory system.
- Endotracheal anesthesia.
Contraindications to general anesthesia in childhood
Planned operations and diagnostic procedures are not performed if the child:
- there are symptoms of an acute infectious disease;
- individual intolerance to anesthetics was previously identified;
- severe cardiovascular failure was diagnosed;
- eating within 5 hours.
Contraindications to the use of inhalation anesthesia are:
- severe respiratory distress;
- severe renal failure;
- increased intracranial pressure due to tumors in the brain, hydrocephalus.
In each specific case, the anesthesiologist individually assesses the ratio of possible risk and the need to use general anesthesia.
How to select anesthesia for children
The most important stage of a child’s preoperative preparation is the search for the optimal type of pain relief. The anesthesiologist carefully studies the baby's medical history, collects anamnesis, identifies possible contraindications and risks in order to minimize the negative impact of general anesthesia on the child's body. When planning anesthesia, he takes into account:
- baby's age and weight;
- anatomical features of the respiratory tract;
- condition of the cardiac and respiratory systems;
- previous diseases and surgical interventions;
- congenital malformations;
- features of the birth of a baby (natural birth, cesarean section, complications during childbirth, etc.);
- genetic history of the baby (health status of immediate family).
Information collected during preoperative preparation helps the anesthesiologist choose the most gentle, yet effective option for general anesthesia, even for the youngest patients.
Before general anesthesia: preparation
Preparation for surgery under anesthesia has a great influence on the effectiveness and safety of general anesthesia and the course of the postoperative period. You will have to undergo a comprehensive diagnostic examination, including detailed blood tests, coagulogram, and ECG. According to indications, consultations with narrow specialists are prescribed.
The presence of chronic diseases of the respiratory and cardiovascular systems is of great importance. Be sure to tell your doctor about the following diseases:
- bronchial asthma;
- chronic obstructive bronchitis;
- arterial hypertension;
- IHD;
- history of stroke.
Do not under any circumstances hide the fact that you have a history of chronic diseases and acute vascular events (heart attack, stroke). Not only the outcome of the operation, but also your life depends on this! Also provide your doctor with a complete list of medications you take, including “harmless” analgesics for headaches or menstrual pain.
As practice shows, excess weight negatively affects the rate of recovery after operations under general anesthesia. If you are planning plastic surgery in advance, pay attention to weight loss issues. It is advisable to quit smoking in about six months. If you have not done this, stop smoking a week before the operation, but you should not “quit” the day before anesthesia - this may complicate the rehabilitation period.
On the eve of the operation, pay special attention to nutrition and hydration. You should not drink alcohol 24 hours before plastic surgery. On the day before surgery, you should limit yourself to breakfast and lunch. On the day of surgery, eating and drinking is strictly prohibited!
Possible consequences for the child after general anesthesia
Exit from the sleep state largely depends on the level of health of the children, the type of anesthesia used and the specific drugs. The average time for full restoration of consciousness is from 1 to 2 hours, the return of cognitive functions is 1–2 days. During this period, the child is under constant medical supervision.
Modern anesthetics are quite safe, and serious negative consequences after anesthesia in children are rare. The most common problems are:
- nausea and vomiting;
- dizziness;
- mild disorientation;
- headache and muscle pain.
With the correct selection of techniques and drugs for anesthesia, high-quality preoperative examination and highly qualified anesthesiologist, the risk of problems is minimal.
After general anesthesia
Even after a good general anesthesia, in the first hours there is short-term confusion, disorientation in space and time, drowsiness, nausea, and dizziness. As the anesthetic drugs wear off, pain appears in the postoperative wound, but it is successfully relieved by the administration of strong anesthetics.
After general anesthesia with an endotracheal tube, patients complain of pain and sore throat caused by irritation of the mucous membrane of the upper respiratory tract, but this symptom, like nausea, passes very quickly. As a rule, patients feel well 3-4 hours after surgery, and on the second day they leave the clinic and return home.
