How to help a child recover quickly after surgery under anesthesia? Negative effects of anesthesia in children: memory, thinking, attention Side effects after anesthesia in children

In most cases about anesthesia we only know that the operation under its influence is painless. But in life it may happen that this knowledge is not enough, for example, if the issue of an operation for your child. What do you need to know about anesthesia? anesthesia, or general anesthesia - it's time limited drug effect on the organism in which the patient is in unconscious when painkillers are administered to him, followed by the restoration of consciousness, without pain in the area of ​​​​operation. Anesthesia may include giving the patient artificial respiration, providing muscle relaxation, setting droppers to maintain the constancy of the internal environment of the body with the help of infusion solutions, control and compensation of blood loss, antibiotic prophylaxis, prevention of postoperative nausea and vomiting, and so on. All actions are aimed at ensuring that the patient undergoes surgery and “wakes up” after the operation without experiencing a state of discomfort.

Kinds anesthesia

Depending on the method of anesthesia it is inhaled, intravenous and intramuscular. Choice of method anesthesia lies with the anesthesiologist and depends on the patient’s condition, on the type of surgical intervention, on the qualifications of the anesthesiologist and the surgeon, etc., because different general anesthesia can be prescribed for the same operation. The anesthetist can mix different types anesthesia, achieving the ideal combination for this patient. Anesthesia is conditionally divided into "small" and "large", it all depends on the number and combination of drugs of different groups. To "small" anesthesia can be attributed to inhalation (hardware-mask) anesthesia and intramuscular anesthesia. With hardware-mask anesthesia child receives an anesthetic drug in the form of an inhalation mixture with spontaneous breathing. Pain medications that are given by inhalation into the body are called inhalational anesthetics ( FLUOROTANE, ISOFLURANE, SEVOFLURANE). This type of general anesthesia is used for low-traumatic, short-term operations and manipulations, as well as for various types research, when a short-term shutdown of consciousness is necessary child. currently inhaled. anesthesia most often combined with local (regional) anesthesia, since in the form of mono anesthesia not efficient enough. Intramuscular anesthesia now it is practically not used and is becoming a thing of the past, since the effect on the patient's body of this type anesthesia the anesthetist is completely out of control. In addition, a drug that is mainly used for the intramuscular type anesthesia - KETAMINE, according to the latest data, is not so harmless to the patient, it turns off long-term memory for a long time (almost six months), interfering with the full development child. "Big" anesthesia- This is a multicomponent pharmacological effect on the body. Includes the use of such drug groups as narcotic analgesics(not to be confused with drugs), muscle relaxants (drugs that temporarily relax skeletal muscles), sleeping pills, local anesthetics, a complex of infusion solutions and, if necessary, blood products. Medicines are administered both intravenously and inhaled through the lungs. The patient undergoes artificial lung ventilation (ALV) during the operation.

Are there any contraindications?

Contraindications to anesthesia no, except for the refusal of the patient or his relatives from anesthesia. However, many surgical interventions can be performed without anesthesia, under local anesthesia (pain relief). But when we talk about the patient's comfortable state during the operation, when it is important to avoid psycho-emotional and physical stress, it is necessary anesthesia, that is, the knowledge and skills of an anesthesiologist are needed. And not necessarily anesthesia in children it is used only during operations. Anesthesia may be required for a variety of diagnostic and medical measures where it is necessary to remove anxiety, turn off consciousness, allow the child not to remember unpleasant sensations, the absence of parents, a forced long position, a dentist with shiny instruments and a drill. Wherever peace is needed child, an anesthesiologist is needed - a doctor whose task is to protect the patient from operational stress. Before a planned operation, it is important to take into account such a moment: if child there is a concomitant pathology, it is desirable that the disease was not exacerbated. If a child has been ill with an acute respiratory viral infection (ARVI), then the recovery period is at least two weeks, and it is advisable not to carry out planned operations during this period of time, since the risk of postoperative complications and breathing problems may occur during the operation, because respiratory infection strikes in the first place Airways. Before the operation, the anesthesiologist will definitely talk with you on topics abstracted from the operation: where you were born child how he was born, whether he was vaccinated and when, how he grew up, how he developed, what he was sick with, whether there are allergies, examine child, get acquainted with the history of the disease, scrupulously study all the tests. He will tell you what will happen to your child before the operation, during the operation and in the next postoperative period.

Preparing a child for anesthesia

The most important is the emotional sphere. It is not always necessary to tell the child about the upcoming operation. The exception is cases when the disease interferes with the child and he consciously wants to get rid of it. The most unpleasant thing for parents is a hungry pause, i.e. six hours before anesthesia can't feed child, for four hours you can’t even drink water, and water is understood as a transparent, non-carbonated liquid, odorless and tasteless. A breastfed newborn can be fed for the last time four hours before anesthesia, and for child located on artificial feeding, this period is extended to six hours. A hungry pause will avoid such a complication during the start anesthesia, like aspiration, i.e., getting the contents of the stomach into the respiratory tract (this will be discussed later). Do an enema before surgery or not? The patient's intestines must be emptied before the operation so that during the operation, under the influence anesthesia there was no involuntary evacuation of the stool. Moreover, this condition must be observed during operations on the intestines. Usually, three days before the operation, the patient is prescribed a diet that excludes meat products and foods containing vegetable fiber, sometimes a laxative is added to this on the day before the operation. In this case, an enema is not needed unless requested by the surgeon. The anesthesiologist has many distraction devices in his arsenal. child from the upcoming anesthesia. These are breathing bags with the image of different animals, and face masks with the smell of strawberries and oranges, these are ECG electrodes with the image of cute muzzles of your favorite animals - that is, everything for a comfortable falling asleep child. But still, parents should be next to the child until he falls asleep. And the baby should wake up next to the parents (if child not transferred after surgery to the intensive care unit).

During the operation

After child fell asleep anesthesia deepens to the so-called "surgical stage", upon reaching which the surgeon begins the operation. At the end of Operation Force anesthesia decreases child wakes up. What happens to the child during the operation? He sleeps without experiencing any sensations, in particular pain. State child assessed by the anesthetist clinically on the skin, visible mucous membranes, eyes, he listens to the lungs and heartbeat child, monitoring (observation) of the work of all vital organs and systems is used, if necessary, laboratory express analyzes are performed. Modern monitoring equipment allows you to monitor heart rate, blood pressure, respiratory rate, the content of oxygen, carbon dioxide, inhalation anesthetics in inhaled and exhaled air, blood oxygen saturation as a percentage, the degree of sleep depth and degree of anesthesia, the level of muscle relaxation, the possibility of conducting a pain impulse along the nerve trunk and much, much more. The anesthesiologist performs infusion and, if necessary, transfusion therapy, in addition to drugs for anesthesia antibacterial, hemostatic, antiemetic drugs are introduced.

Getting out of anesthesia

Exit period anesthesia lasts no more than 1.5-2 hours, while the drugs administered for anesthesia(not to be confused with the postoperative period, which lasts 7-10 days). Modern drugs can reduce the period of withdrawal from anesthesia up to 15-20 minutes, however, according to tradition child should be under the supervision of an anesthesiologist within 2 hours after anesthesia. This period may be complicated by dizziness, nausea and vomiting, pain in the area of ​​the postoperative wound. In children of the first year of life, the usual sleep and wakefulness pattern may be disturbed, which is restored within 1-2 weeks. The tactics of modern anesthesiology and surgery dictate the early activation of the patient after surgery: get out of bed as early as possible, start drinking and eating as early as possible - within an hour after a short, low-traumatic, uncomplicated operation and within three to four hours after a more serious operation. If a child after the operation is transferred to the intensive care unit, then further monitoring of the condition child the resuscitator takes over, and here continuity in the transfer of the patient from doctor to doctor is important. How and what to anesthetize after surgery? In our country, the appointment of painkillers is carried out by the attending surgeon. It can be narcotic analgesics ( PROMEDOL), non-narcotic analgesics ( TRAMAL, MORADOL, ANALGIN, BARALGIN), non-steroidal anti-inflammatory drugs ( KETOROL, KETOROLAC, IBUPROFEN) and antipyretics ( PANADOL, NUROFEN).

Possible Complications

Modern anesthesiology seeks to minimize its pharmacological aggression by reducing the duration of action of drugs, their number, removing the drug from the body almost unchanged ( Sevoflurane) or completely destroying it by the enzymes of the organism itself ( REMIFENTANIL). But, unfortunately, the risk still remains. Although it is minimal, complications are still possible. The inevitable question is what complications may occur during anesthesia And what consequences can they lead to? Anaphylactic shock -allergic reaction for the administration of drugs anesthesia, for transfusion of blood products, with the introduction of antibiotics, etc. The most formidable and unpredictable complication that can develop instantly can occur in response to the introduction of any drug in any person. Occurs at a frequency of 1 in 10,000 anesthesia ov. It is characterized by a sharp decrease in blood pressure, disruption of the cardiovascular and respiratory systems. The consequences can be the most fatal. Unfortunately, this complication can be avoided only if the patient or his immediate family had a similar reaction to this drug and it is simply excluded from anesthesia. An anaphylactic reaction is difficult and difficult to treat, the basis of therapy is hormonal preparations(for example, ADRENALIN, PREDNISOLONE, DEXAMETHASONE). Another formidable complication, which is almost impossible to prevent and prevent, is malignant hyperthermia- a condition in which, in response to the introduction of inhalation anesthetics and muscle relaxants, the body temperature rises significantly (up to 43 degrees C). Most often, this is a congenital predisposition. The consolation is that the development of malignant hyperthermia is an extremely rare situation, 1 in 100,000 general anesthesia. Aspiration- Entry of stomach contents into the respiratory tract. The development of this complication is most often possible with emergency operations if a little time has passed since the last meal by the patient and the stomach has not been completely emptied. In children, aspiration may occur during a face mask anesthesia with passive leakage of stomach contents into oral cavity. This complication threatens with the development of severe bilateral pneumonia, complicated by burns of the respiratory tract by the acidic contents of the stomach. Respiratory failure - a pathological condition that develops when there is a violation of oxygen delivery to the lungs and gas exchange in the lungs, in which the maintenance of normal blood gas composition is not ensured. Modern monitoring equipment and careful observation helps to avoid or diagnose this complication in time. Cardiovascular insufficiency - a pathological condition in which the heart is not able to provide adequate blood supply to the organs. As an independent complication, it is extremely rare in children, most often as a result of other complications, such as anaphylactic shock, massive blood loss, and insufficient anesthesia. A complex of resuscitation measures is being carried out, followed by a long-term rehabilitation. Mechanical damage - complications that may arise during the manipulations performed by the anesthetist, whether it be tracheal intubation, venous catheterization, gastric tube insertion, or urinary catheter. A more experienced anesthetist will experience fewer of these complications. Modern drugs for anesthesia passed numerous preclinical and clinical trials - first in adult patients. And only after several years of safe use they are allowed in pediatric practice. The main feature of modern drugs for anesthesia is the absence adverse reactions, rapid elimination from the body, the predictability of the duration of action from the administered dose. Based on this, anesthesia safe, has no long-term effects and can be repeated repeatedly. Without a doubt, the anesthesiologist has a huge responsibility for the life of the patient. Together with the surgeon, he seeks to help your child cope with the disease, sometimes single-handedly responsible for saving life.

The need for anesthesia during operations or some types of diagnostics in babies often scares parents. You can often hear that anesthesia is harmful, it affects the brain of a child, but is this true? To understand this issue and determine the degree of influence of this type of anesthesia on the baby's body, you need to know what types of anesthesia exist, what are their features, whether they can lead to any consequences.

Anesthesia in pediatric practice is divided into types, based on how the delivery takes place. active substance in the body of children. If it is delivered through the lungs - this is inhalation anesthesia, if by introduction into the body, through a vein - intravenous. Each of the types of anesthesia has its own advantages and disadvantages, it is impossible to say unequivocally that one of the types is better than the other. A specific type of anesthesia during a particular operation, manipulation or special diagnostics requires an individual approach in choosing. It depends on many factors:

• The doctor himself and his experience with certain drugs;
• Availability necessary medicines in a hospital and equipment for their delivery;
• From the task that the surgeon sets and the type of access (from the back, from the abdomen, special positions), the volume of intervention and the duration of the operation;
• From the characteristics of the child, the presence of somatic or infectious pathologies, metabolism, weight, the presence of allergic reactions to medications and anesthetics;
• From what kind of operation it is - planned or urgent (emergency), which determines the amount of preparation necessary for it.

In different hospitals, the same interventions may imply different anesthesia, it depends on the equipment of the hospital and its staff, the availability of drugs, and even whether this operation is paid or free. In addition, it is important to know that the anesthesiologist during the intervention can combine various methods pain relief, using drugs that are acceptable for children, relaxing muscles and turning off consciousness. This is necessary so that children do not feel pain, discomfort and stress during the intervention, and operations (or other necessary actions) were successful.

How is general anesthesia performed in pediatric practice?

If we are talking about an emergency situation, children are operated on as soon as possible, and general anesthesia is carried out with quick and active techniques, we are talking about saving health and life. The doctor focuses on the specific situation, using the method that will be faster and more efficient. If the operation is planned, it is possible to fully prepare for it, which will minimize the risk of complications. For surgery and general anesthesia, the child must be healthy - exacerbations chronic pathology, acute infections become temporary contraindications for intervention. Under these conditions, general anesthesia is associated with a high risk.

Before general anesthesia is performed, the anesthesiologist talks with the parents and examines the child, and only then does he give permission for the operation. He tells parents in detail about what kind of anesthesia is planned and how much preoperative preparation needed, which is required from the parents and the baby himself to the best of age.

Before introducing the baby into anesthesia, it is recommended that one of the parents (or relatives, guardians) be directly with him until he falls asleep and enters the anesthesia state. To introduce a child into a state of anesthesia, special masks and breathing devices are used only child type selected according to age.

After the children enter drug-induced sleep, doctors use drugs in order to achieve maximum relaxation of the muscles and achieve complete pain relief. While the child is under anesthesia, surgeons proceed to surgical intervention. Throughout the operation, the anesthesiologist monitors the vital signs of the child under anesthesia, and, if necessary, regulates the supply of drugs. As the operation is completed, the doctor reduces the concentration of drugs in the dropper or in the inhaled mixture, which leads to the fact that the child comes to his senses. While the baby is under anesthesia, his consciousness is completely turned off, he does not feel pain impulses, breathing usually occurs due to the ventilator, and the monitors reflect the indicators of pulse and pressure, blood oxygenation and some others.

What happens after anesthesia

The exit from the state of anesthesia is largely determined by the type of drug and the rate of its removal from the plasma. The child can completely move away after anesthesia for two or more hours, and sometimes due to the use of modern methods- and earlier. However, even if the child feels well and the operation is successful, the anesthesiologist carefully observes the child for the first few hours after anesthesia. At this time, children often complain of nausea or vomiting, pain in the wound area may be felt. In infants, after anesthesia, the usual regimen may go astray for a while.

Today, due to the fact that operations are becoming less and less traumatic, they try to activate patients already on the very first day after anesthesia. If the operation was small, the children can move, and sometimes even get up after two or three hours, if the operation was more extensive, after 4 or more hours. Only in case of a serious condition or the need for resuscitation measures, constant monitoring, children are transferred to intensive care and intensive care units (usually this happens with very extensive and difficult operations, where there is a large blood loss or duration of intervention, many incisions and wounds).

During the operation, doctors will do everything possible to minimize the risk of complications, however, the body is a complex system, and not all of its reactions can be predicted. Children may experience complications as a result of taking medications, bleeding as a result of tissue dissection, as well as the body's reaction to the disease itself and unforeseen circumstances that could only be clarified with intervention. Allergic reactions, including anaphylactic shock to administered medications, are rightfully considered the most basic of the complications. There may also be febrile reactions to the use of anesthesia, which will require special lytic therapy during the intervention. In addition, there may be complications of the operation itself - bleeding, thrombosis, which doctors eliminate in a timely manner and, if possible, warn in advance.

Often anesthesia scares people, sometimes even more than surgery. Most fearful of the unknown and possible discomfort when falling asleep and waking up. Do not tune in to the positive and numerous conversations that it is dangerous to health. It becomes especially alarming when it comes to the fact that the operation will be performed on a child, and in children it causes negative consequences.

Children's anesthesia - how safe is it for a young organism?

Operations under anesthesia in children are carried out according to the same rules as in adults, taking into account age features. In children, due to anatomical and physiological characteristics, more often than in adults, there are critical conditions, the removal of which requires resuscitation and intensive care. However, in modern medicine exclusively gentle means are used that can introduce an adult and a child into an artificially induced deep sleep.

Anesthesia for children is a loss of consciousness caused by a set of special preparations. It may include many manipulations aimed at facilitating the process of falling asleep, surgery, and awakening. Among the activities carried out are:

• • Setting up drips.
  • Installation of a control system, compensation for blood loss.
  • Prevention of the consequences of the operation.

Parents should understand the essence and risk of anesthesia, the features of the types of anesthesia and contraindications to its use, be sure to tell the doctor:

• • • How was the pregnancy and childbirth?
    • what was the type of feeding: breastfeeding (how long) or artificial;
    • what the child was sick with;
    • reactions to vaccinations;
    • whether he and his next of kin have allergies.

All this is especially important for children. early age, you need to ask the anesthesiologist questions if something is not clear, and the final decision on which anesthesia or anesthesia to carry out is up to the doctor!

Types of pain relief techniques used

In medical practice, there are several types of anesthesia:

• • • Inhalation or hardware-mask - the patient receives a dose of painkillers in the form of an inhalation mixture. It is used when carrying out short simple operations.

See its action and main stages in this video:

• • • Intramuscular anesthesia for children today is practically not used. Because he cannot control the duration of sleep. The drug Ketamine used is harmful to the body. It can turn off long-term memory for almost 6 months, which affects the full development.
    • Intravenous - has a multicomponent pharmacological effect on the body. Ventilation of the lungs is performed by a special apparatus. Anesthesia is used for children extremely rarely, exclusively with urgent need.

Are there contraindications?

Anesthesia for children can always be carried out, with the exception of the refusal of the patient or relatives from the procedure. However, before carrying out a planned operation, it is important to take into account all the nuances, features:

• • • The presence of pathologies different nature that can negatively affect the state during sleep and recovery.
    • If the patient has recently had ARVI or another viral infection, the operation should be postponed for several weeks until full recovery organism.
    • The presence of allergies to drugs. The doctor examines the records in the card in detail. In case of finding out about the presence of an allergy to medicines, he immediately changes the tactics of action.
    • Health features - heat, runny nose.

Before surgery, the anesthesiologist examines the patient's card in detail, noting all the points that may affect the method of anesthesia. In addition, a conversation is held with parents, in which important points are clarified.

How to prepare a child for anesthesia?

According to modern concepts, any surgical interventions, painful procedures, diagnostic studies in children (especially younger ones) should be carried out under anesthesia or sedation! Young children simply do not know what is ahead of them, and no premedication is needed.

Regardless of the type of anesthesia under which the operation is planned, the patient is preliminarily prepared for surgical intervention.
Age groups of children: newborns, up to 6 months, 6-12 months, 1-3 years, 4-6 years,
7-9 years old, 10-12 years old, over 12 years old.

The anesthesiologist takes an active part in preparing the child for surgery. At planned operations all preparation can be divided into general medical and pre-anesthesia: psychological and pharmacological premedication. An obstetric history is important: how did the pregnancy and childbirth go (on time or not), the anthropometric data of the child - the correspondence of body weight and height to his age, psychomotor development, visible violations from the side musculoskeletal system, behavioral responses.

Psychological preparation: hospitalization for a child is a difficult moral test, he is frightened by separation from his mother, people in white coats, the environment, and so on. Anesthesiologist, attending physician and charge nurse help and explain to mom how to behave.

Doctors recommend not always telling the baby about what is to come. The exceptions are cases when the disease interferes with him, and he wants to get rid of it. However, if the children are old enough, it is necessary to explain that a special children's will be carried out, as a result of which they will fall asleep and wake up when everything has already been done and there is no trace of the past illness.

It is desirable that the baby is calm and not afraid. It is necessary to provide rest both emotional and physical. The main thing that parents need to remember is that the baby should wake up after anesthesia and see the dearest and closest people to him.
Once again about the most important thing in this video:

General anesthesia: consequences for the child's body

Much depends on the professionalism of the anesthesiologist, since it is he who selects the necessary dosage used for anesthesia. medicines. The result of the work of a good specialist is the child's being in an unconscious state during the period necessary for surgical intervention, and a favorable recovery from this state after the operation.

Crane rarely happens intolerance to drugs or their components. It is possible to predict such a reaction only if the patient's blood relatives had it. Now we will list the consequences that may arise as a result of drug intolerance, but we note once again that this is an extremely rare case (only 1-2% probability):

• anaphylactic shock;
• malignant hyperemia. A sharp rise in temperature to 42-43 degrees.
• cardiovascular insufficiency;
• respiratory failure;
• aspiration. Ejection of stomach contents into the respiratory tract.

Some studies also suggest that anesthesia can damage the neurons in a child's brain, leading to cognitive disorders. At the same time, memory processes are disturbed: absent-mindedness, inattention, deterioration in learning and mental development appear for some period after the operation. These processes are opposed by a number of factors:

1. the likelihood of such consequences is highest with intramuscular anesthesia using Ketamine. Now a similar method and drug is practically not used for children.
2. children under two years of age are at greater risk. Therefore, operations under anesthesia, if possible, are postponed for a period after 2 years.
3. the validity of the conclusions made by only a few studies has not been conclusively proven.
4. these symptoms pass quite quickly, and operations are done in connection with real health problems of the child. It turns out that the need for anesthesia exceeds the possible temporary consequences of it.

Parents should understand that the condition of their baby throughout the operation and for 2 hours after it is monitored by a modern Medical equipment and staff. Even if there are any consequences, he will be provided with the necessary assistance in time.

Anesthesia is an ally that helps the child get rid of health problems in a painless way. Therefore, parents should not worry too much.

In modern medicine, anesthesia is a sparing tactical means, the use of which during an operation is a must.

If you have any questions - we will be happy to answer them. Health to your children!

I created this project to plain language tell you about anesthesia and anaesthesia. If you received an answer to your question and the site was useful to you, I will be glad to support it, it will help to further develop the project and compensate for the costs of its maintenance.

Related questions

Tatyana 10/16/2018 09:43

Good afternoon. On October 1, we had an operation to remove adenoids under general anesthesia. At first, the daughter (4 years old) complained of headaches. After 12-14 days, she periodically began to complain that she could not open her eyes. I thought maybe it was the vinegar fumes, or the smell of onions (complaints in the kitchen). Then it happened more often after waking up. It opens well, then the eyes could not stand being open. And this is not only in the sun but also in the shade. Today, she still couldn't open her eyes completely. Difficulty blinking or eyes closed. Whether there can be it a consequence of an anesthesia? And what can be done?

Valentine 17.09.2018 20:37

Good evening! My son is 4 years and 9 months old, he broke his arm, two bones were broken, one bone was displaced. On the day of the fracture on 11.09, general anesthesia was performed, one bone was straightened, the second remained fractured with displacement. A week later, on September 19, re-administration under general anesthesia. Help with advice, please, is it very dangerous? What consequences?

Olga 27.08.2018 18:33

Good afternoon. The child had the first operation in March, repeated in early August. In both cases, general anesthesia was used. After the first operation, there was an increase in weight, insignificant, but we cannot reduce the weight. Could anesthesia affect metabolism?

Evgenia 08/25/2018 00:09

Hello, Doctor! After the operation to remove the adenoids, my grandson (3 years and 4 months) is not only whiny and nervous, but he has strange psychoses: for example, he demands to go from home to the bus stop again and come back just because his mother did not give him a hand, or got out of the house first, instead of letting him out. Or suddenly he demands to feed his little sister with cucumber in the middle of the night and cries loudly, hysterically, until he achieves his goal .... We are at a loss. We don't know what to do. I think that he just has whims, but it turns out that general anesthesia has a very bad effect on the child's psyche. What do we do now? How to treat it? Help me please!!! Sincerely, Evgenia Grosh

Vladislav 06/07/2018 12:26

Hello. My mom had a very "rapid" delivery with me, my head was half blue. At the age of six, and this is 1994, to the surprise of my mother and doctors, hemorrhoids of the acute stage came out. In the hospital, I had three operations under general anesthesia, a year later two more operations, also under general anesthesia. At the age of 12, a knee injury and again general anesthesia. Now I am 29 years old. From about the age of 7 until the age of 20, I constantly suffered from headaches and low pressure. Now my head hurts very rarely, but I understand that weakness, drowsiness are my enemies for life. I also see the diagnosis "bradycardia" at regular medical examinations from work every year. Is my state of endless weakness a consequence of 6 general anesthesias in childhood?

Alexander 05/28/2018 11:05

Hello, my child is 10 years old. When falling from a height, he hit his head and received a moderate (or severe, I don’t know exactly) concussion. (there was a short-term loss of consciousness about 30-60 seconds), memory loss (does not remember what happened immediately before the fall and the fall itself), also broke his forearm (both radius bones). In traumatology, a plaster cast was immediately applied, but with a second x-ray after 1 day, it was found that the displacement persisted. Doctors say it is necessary to do general anesthesia and combine the bone. Question: Is anesthesia dangerous on the third day after a concussion, and is general anesthesia really necessary for a 10 (almost 11) year old child? Maybe it was possible to get by with a local (after all, he is not quite small and is able to sit quietly)? Thanks in advance for your reply!

Inna 19.04.2018 17:10

Hello. Dear doctor, tell me, please - to my son (7 full years) in February had an operation to remove appendicitis (with peritonitis). Now we are going to have an operation to remove two hernias (umbilical and white line of the abdomen). How dangerous is it to do general anesthesia after such a short period of time? THANKS!

Guzel 04/06/2018 13:41

Good afternoon doctor. The child is 2 months old, we were sent for an MRI (diagnosis of paresis of the III cranial nerves on the left, partial ptosis of the upper eyelid on the left, ophthalmoplegia), but the child fell ill, the child has snot. Can I have an MRI immediately after recovery or do I have to wait a while? And one more question: I'm going to be under general anesthesia. How dangerous is this for a child?

Elena 31.03.2018 20:54

Hello doctor, a child of 12 years old needs to have a papilloma removed on the palatine arch, doctors insist on general anesthesia. What now modern drugs are used. What to talk about with an anesthesiologist?

Anastasia 03/27/2018 21:28

Hello. Please advise what consequences can be after anesthesia, is it worth doing the operation now, or is it better to wait up to 2 years? Situation: the baby is 4 months old, we have polydactyly, the 6th finger (on the big one 2 pcs). At what age is it better to have an operation, because now the (thumb) finger is growing, and it becomes uneven due to the second ..?

Natalia 03/27/2018 07:38

Hello. Tomorrow, my son, 6 years old, will have treatment and extraction of teeth under mask anesthesia. The anesthesiologist said that for 21 days there should be no snot. what is it connected with? I understand that SARS should not be transferred, but snot if they are dry indoors in the morning?

Lily 03/02/2018 14:50

Hello, Doctor! a child of 5 years old, on Monday, March 5, goes to a planned operation to remove a nevus on the thigh. the child was born prematurely at 33-34 weeks, of course, there was hypoxia and a slight cerebral edema, he was on a ventilator. up to a year, hydrocephalic syndrome was detected, which was treated with diacarb. at 1 year and 4 months they received CTBI, they were in the hospital, after that epilepsy (absences) was questionable, but the doctors themselves do not know if there is or not, who says what is, who is not. Now, according to my observations, everything is calm. on the this moment There is a small anomaly in the development of the heart. before the operation, as expected, a general blood test was done, all indicators are normal, but NEU is reduced by 34.2% at a rate of 40.0-75.0, LYM is increased by 41.6% at a rate of 2.01-40.0, MON is increased by 9.6% at a rate of 3.0-7.0, EO is increased by 13.1 %! at a rate of 0.0-5.0. Please tell me: 1 is it possible to carry out general anesthesia in our case? 2 Do ECG and allergy tests for anesthesia before surgery? 3 What kind of anesthesia is used everywhere when removing nevi?

Natalya 16.01.2018 00:25

Hello, Doctor. Please tell me how to prepare a child 1.9 for surgery? The operation is due in two months., still present breast-feeding basically at night the question is: to wean the child now from the breast or after the operation, will the baby help or harm during the operation? Thanks in advance for your reply.

Victoria 12.12.2017 13:50

Hello. My son (3.5 years old) was scheduled for a planned operation to remove umbilical hernia and hernia of the linea alba. 10 days left. The child has not had a rash for about three weeks now (manifestation of an allergy), from time to time complained of pain in the abdomen (now it seems to be gone). The cause of the allergy has not been established. Is it possible to do an operation or is it more reasonable to first undergo an examination by a gastroenterologist, to identify the cause of the operation? If so, how long should it take for the rash to go away? Thank you!

Marina 11/28/2017 22:48

Hello! We are scheduled for a planned operation in the sky (cleft hard, soft palate) in 6 days, on the other side of the country. They waited for their turn for a long time - 6 months, they passed all the examinations - everything is fine. But the child picked up the virus: The snot is liquid and coughs. Tell me, is this a contraindication to surgery? Or is it possible to give antibiotics for a couple of days and go to the operation? Is it possible to do surgery / anesthesia with snot if we do not have time to cure it? And what could be the consequences? Thanks for the answer!

ANNA 11/16/2017 08:25

Hello, a 2-year-old child was scheduled for an operation (general anesthesia), after 10 days the operation, but we caught a cold, we were prescribed the antibiotic cephalexin. Are there any contraindications to general anesthesia after its use?

Julia 13.11.2017 20:01

The dear doctor, I ask you prompt. Treatment of 2 front teeth for a son aged 1, 10 months, after a blow, a flux formed on the gum. Treatment options are available with or without anesthesia. Carry out under intravenous anesthesia so as not to injure the child's psyche, or treat in spite of fear - but refraining from anesthesia? Is it right not to resort to anesthesia in such a critical situation? Thanks in advance!

Olga 09.11.2017 11:20

Hello, the child is 2.2 years old, at 1.3 g, an operation was performed to remove the inguinal-scrotal hernia, at 1.5 g there was a relapse (they operated on at 1.9 g), now there is a relapse again, there will again be an operation under general anesthesia, what could be the consequences of general anesthesia so often?

Fagana 03.11.2017 02:54

Hello, my son is 2 months old, we want to do a circumcision, they will probably do it under anesthesia, please tell me whether it is worth exposing the body at that age small child anesthesia, or if there is no need to wait to grow up?

Antonina 01.11.2017 22:14

Hello. Daughter is exactly 2 years old. Found an inguinal hernia on the right. An operation is coming. We cannot decide between laparoscopy and abdominal method. The surgeon said that in the first case anesthesia will last 30-40 minutes, and in the second 10 minutes. Tell me, is the difference of 20-30 minutes under anesthesia so harmful, as the doctor claims? The first method is more gentle, as well as the postoperative period is easier, we see only pluses. The child is capricious and very mobile, therefore we do not want a cavity. It is only this difference in time under anesthesia that hinders the choice of laparoscopy. Thank you.

Julia Prokhorova 10/19/2017 16:53

Hello, we have an inguinal hernia confirmed at 2 months old, now our daughter is 6 months old. We are advised to wait with the operation for up to a year, but there is no strength to wait and suffer, the child tries to crawl and the hernia protrudes. We, the parents, are afraid that the infringement can be at any moment . The child's tests are good (blood and urine), she is mobile and develops on time, she was born at 39 weeks with hypoxia, according to Apgar scores 7-8, the diagnosis is perinatal damage to the central nervous system of hypoxic-inschemic origin, PVC on the right is 1-2 st, pseudocyst of the left vascular plexus .response to vaccination against pneumococcus-temperature 38°C. Is an operation possible with such diagnoses at 6 months?

Eugene 10/17/2017 18:57

Hello! A boil was cut out for a boy at 2.9, i.e. was general anesthesia. Now I discovered that we have an inguinal hernia, you can’t confuse it with anything. I don't think we can do without surgery. Tell the doctor how harmful anesthesia will be if the interval between operations is only 2-3 months? And what consequences can be after such operation. Thanks in advance for your reply.

Olga 13.08.2017 15:44

The child is 2.6 years old. Laryngoscopy and cryodestruction of soft tissues were performed. Mask anesthesia, after 20 minutes the child woke up. After 8 days, they want to do laryngoscopy again under anesthesia. Is it often possible?

Olga 08/09/2017 15:46

The child is 1.10 months old and is going to have an operation under general anesthesia. The diagnosis is stenosing ligamentitis of the 1st left hand. Question: what kind of anesthesia is given to children at this age and is there any point in waiting until 2 years old

Yana 08/07/2017 00:07

My daughter (4.5 years old) has grade 3 adenoids and hypertrophied tonsils. Breathing is difficult, ENT recommends removal. BUT, because daughter is registered with a neurologist (absences), then the hospital asked for a conclusion from a neurologist that general anesthesia can be done. A neurologist does not give a conclusion without an examination in a hospital where you need to do an MRI under anesthesia. And it turns out a vicious circle. Is it possible to do an MRI under anesthesia for adenoids?

Marina 05.08.2017 20:03

Hello! My child is 5 years old, she broke 2 bones of her arm with a displacement, they tried to set them intravenously under anesthesia, but it didn’t work out. The needles were inserted under general anesthesia, after 1.5 months the needles were removed under anesthesia. Half a year later, the arm was again fractured with sciatica, it was set under anesthesia, after 2 weeks in the picture - displacement, the orthopedist suggests again under anesthesia to set the bone. Is such frequent administration of anesthesia 5 times in six months dangerous for the body, what are the consequences?

Love 13.07.2017 11:48

Hello, Doctor! My grandson had a papilloma removed from his cheek two days ago. They did it under anesthesia-mask, the whole procedure took about 20 minutes, I quickly and easily came to my senses. The wound is tiny. They were supposed to be discharged tomorrow, but the daughter wrote a refusal and took it today, because. there are many patients, every day they were transferred from ward to ward. He had a fever and vomited twice. Whether it is a consequence of an anesthesia. No one in our family had allergies or drug intolerance.

Natalya 07/05/2017 19:00

Good afternoon! Son 1.2. A month ago, on the back, closer to the right shoulder blade, I found a bump (not hard, painless, does not grow). The doctors said it was either a lipoma or another tumor. They told me to go in for surgery. That only after the operation they will say what it is. Scared of a malignant tumor. Is it possible to somehow determine what kind of cells these are before the operation? The child is only a year old, anesthesia scares me twice. Before the operation, CT under anesthesia and at the operation again anesthesia. Is there a chance that education will dissolve? Appeared sharply at once with a size of 2 * 3 cm.

Ekaterina 06/22/2017 00:51

Hello, Doctor! Son is 10 years old. Next week, a scheduled operation to remove the inguinal-scrotal hernia is due. Which anesthesia is better and safer at this age? Is anesthesia safe if the ECG showed the following: sinus arrhythmia heart rate 68-89 beats / min; vertical direction of the EOS; incomplete blockade right leg bundle of Hiss. Is it possible to use general anesthesia with such an ECG? Unfortunately, we do not have a pediatric cardiologist in our city. Many thanks in advance for your reply!

Eugene 14.06.2017 12:21

Hello. A 6-year-old girl was prescribed cutting of the frenulum: under the tongue and upper lip. They offer general or local anesthesia. They advise a general one so that the child is not afraid. But is general anesthesia justified for such a minor operation, which will take no more than 10 minutes?

Natalia 05/24/2017 13:45

Hello. My baby is 2.5 months old. You will have a cystoscopy under general anesthesia. A week ago, a runny nose appeared, aquamaris dripped, saline solution, snot did not go away in a week. When he sucks through his nose, he breathes normally, otherwise he "grunts". The operation is planned. Should I go to bed for surgery or is it better to wait?

Ekaterina 05/11/2017 09:48

Hello! This coming Monday, a 9-month-old baby will have an operation with anesthesia. The diagnosis is hypospadias. The last few days the child has a runny nose. Washing and instillation of the Nose did not improve the situation significantly. Is it possible to give anesthesia with a cold or is it better to postpone the operation?

Christina 09.05.2017 08:07

Hello dear doctor. I have this question. Child 1.7 will have surgery for craniostenosis. I'm sooooo worried about long-term anesthesia. Since we were born at 30 weeks and at birth, we were diagnosed with PTCNS of hypoxic-ischemic genesis. From birth to this day, the child was treated so that there was no lag in psychomotor development. And now the first long-term anesthesia is coming. Tell me how to act later so that anesthesia does not affect psychomotor and speech development, does not start a delay or stop talking altogether?

Victoria 05/08/2017 00:41

Hello, Doctor! We really need your opinion! My child is 5 years old, they put adenoids of 2-3 degrees. Sleeps with open mouth, does not snore, the mouth is also periodically open during the day, every month colds. They suggest an operation, but they did not ask about the characteristics of the child. We have minor anomalies of the heart, functioning oval window 2mm. , the cardiogram is normal, we are observed by a neurologist (sent to an encephalogram), during childbirth there were complications of asphyxia, a constantly bluish color of the bridge of the nose and nasolabial triangle, also an allergy to washing powder and some types of drugs. About two months ago I had otitis media. Adenoids were checked two weeks after a cold. Ketamine is offered intravenously for five to ten minutes. Is it possible to use anesthesia for my child with such indications, because I do not agree to local anesthesia, or is it better for us to do an encephalogram first? Or do you need to give up and wait?

Anna 20.04.2017 12:39

Hello! My daughter is 4 years old, she needs to do an SCT of the nose and sinuses, but she refuses to lie down! What tests do I need to pass for anesthesia?

Ekaterina 04/20/2017 10:20

Hello, the child is a year and 5 months old. We were diagnosed with ataxia. I want to do an MRI of the brain in order to clearly understand the whole picture of what this ataxia is, so that they can prescribe the right treatment. But the neurologist and osteopath dissuade that anesthesia is very dangerous. risk of MRI under anesthesia for ataxia?

Anastasia 04/05/2017 19:39

Dear doctor, my son is 1.5 years old, a month and a half ago, an inguinal hernia was discovered, the surgeon signed up for a planned operation to remove it, he is afraid of general anesthesia, the doctor says it is more dangerous not to have an operation. How dangerous is anesthesia, which method of anesthesia is safer, do you need any restorative drugs after anesthesia? Thanks in advance!

Elena 03/27/2017 00:31

Hello. My son is 2 years and 4 months old. Behind in the upper part of the thigh, a neoplasm was found. According to the conclusion of the ultrasound myoma, the dimensions are 40 mm by 20 mm. Doesn't bother, doesn't hurt. The ultrasound doctor advises not to operate, as he claims that this is a benign formation, the surgeon advises to operate ... What do you say? I'm very afraid of surgery, especially anesthesia, I'm afraid of any complications ... anything can happen ... What kind of anesthesia is acceptable in our case? Thank you in advance!

Svetlana 25.03.2017 12:40

Hello, Doctor. Daughter 10 months. On Tuesday, March 21, the child underwent an operation to remove a hemangioma (dermal-subcutaneous, diameter 5 cm) on the back. Indubated because the operation was performed in a lateral position. On Wednesday morning, after the dressing, the attending physician said that he would not be discharged yet, because the babies may have distant reactions to anesthesia, and swelling remained on the wound. On Wednesday, at 6 pm, the child began to vomit, which remained after the injection of cerucal, by night the temperature rose above 39, they knocked down analgin with diphenhydramine, it went down only to 38, by morning it began to rise. There was no vomiting on Thursday. There was no diarrhea, there was loose stools once or twice a day. Tell me, please, is such a reaction really possible a day after the operation? With the permission of the doctors, I fed the child with the usual diet, that is, cereals, vegetable, meat and fruit purees, although canned, industrial production. At home she supplemented with expressed breast milk, but in the hospital it was not possible to express, she supplemented with a mixture of nan1. Before the operation, we treated dysbacteriosis (Klebsiella, Staphylococcus aureus) for 8 months. The analysis before the operation was normal (Klebsiella was within the normal range, staphylococcus was not detected). Have you encountered such cases in your practice? Or is it an intestinal infection, or poor-quality puree, or teeth (only 1 grew, the second one swelled), or a reaction to medications, or did it all coincide and was aggravated by the operation? Now the child has no vomiting and no temperature, for three days he was put on drips with glucose and Ringer's solution, and yesterday they also did ceftreaxone intravenously once. I give Acipol with water. I started eating myself last night - oatmeal on the water and a small amount of breast milk. Since morning there was a liquid chair once.

Alexandra 21.03.2017 12:51

Hello, in January 2017 there was an operation with general anesthesia for my son (6 years old), in May another operation with general anesthesia was prescribed for a different diagnosis, is the gap between anesthesia small and how to minimize the consequences of complications.

Angela 15.03.2017 16:55

Hello, my 9-year-old daughter has a seal on her foot under her finger, a granuloma is questionable, we are going to cut it out. The doctor wants to do general anesthesia, but I doubt it is necessary, isn’t it already possible to do local anesthesia?

Natalya 09.03.2017 04:47

Hello. My child underwent angiography with embolization. There was a hemangioma on the cheek. After that, she was in intensive care for a day. Then they gave it to me. She ate and slept all day. The condition was lethargic. Now the third day after the procedure. Very capricious. Not so active. What I didn’t like so this crying for no reason is strong, it bends and rolls its eyes up. though this happened twice a day. we are 5 months old, they inject antibiotics. tomorrow bypass. but I would like to read your answer. I think we cannot do without a neuropathologist.

Irina 03.03.2017 12:50

Good afternoon! Three days ago, the child was treated for teeth under general anesthesia (intramuscularly). Thus we treat already the third time. Teeth decayed rapidly. 8 teeth were treated at once, the volume of destruction was large. The child was not given to doctors under any pretext, and therefore anesthesia was used. This time there were two removals and two fillings. The teeth that were removed were practically absent, therefore, again, anesthesia. For two nights the child wakes up and screams, for a short time, but very emotionally. During the day, too, unnecessarily excitable and anxious. Tell me, please, should we go to the doctors with this problem, or is it the consequences of stress and over time the situation will normalize. Thank you in advance

Hope 03.03.2017 06:05

Hello! The child is 6 years old, diagnosed with Ecdodermal ahydroctic dysplasia, i.e. dryness of all mucous membranes, impaired thermoregulation of the body. We want to do otoplasty under general anesthesia, please tell me if general anesthesia is possible?

27.02.2017 14:27

Sergei, in the hands of an experienced pediatric anesthesiologist, everything will go well. It is necessary to examine the child, anesthesia will not have a significant side effect.

Cyril 22.02.2017 10:37

Hello! The child is 1 year and 10 months old. She has strabismus, the doctor says it is necessary to have an operation under general anesthesia, either now or at 4 years 6 months. We don’t know what to do, agree now or wait until 4 years ??? age to make it safer for the health of the child ???

Tatiana 19.02.2017 00:04

Hello! A 4-year-old child has residual encephalopathy with mental retardation. We want to treat and remove teeth under general ketamine anesthesia. There is also an allergy in the form of rashes to certain drugs. They said that perhaps the teeth will be treated in 2 stages with an interval of a week, i.e. anesthesia will be 2 times. Is it possible to do such anesthesia for an allergic person? Will anesthesia affect the development of a child who is already lagging behind? Thank you.

Zebo 12.02.2017 15:09

Hello. A 5-month-old child is scheduled for an operation under anesthesia. They will operate on his hand for a born constriction of the left forearm. And his leukocytes are 12.9. Why is it dangerous?

Angelina 27.01.2017 09:41

Dear doctor, hello. My daughter is 16 years old, she is going to have an ENT operation. The anesthesiologist offers to choose anesthesia, says that there is a good paid and free one. In addition, they also offer a good paid injection (3000-5000 rubles) after anesthesia, so that the child "easily" comes to his senses. I doubt very much whether there is something similar in medicine. Help, please, to understand.

Ulyana 24.01.2017 23:53

Sergey Evgenievich, what do you think if a child (5 years old) allergic rhinitis, manifested by nasal congestion at night on the one hand, seasonal rhinitis, can it be dangerous or a ban on performing an operation under anesthesia? Thanks in advance.

Why is general anesthesia dangerous for a child? Yes, in some cases it is necessary. Often - to save the life of a child.

But there are also negative aspects of the action of anesthesia. That is, it is like a coin that has two sides, like a double-edged sword.

Naturally, before the upcoming operation for the child, parents are trying to find out how dangerous this intervention is, what exactly is the danger of general anesthesia for the child.

Sometimes general anesthesia scares people even more than surgery. In many ways, this anxiety is fueled by numerous conversations around.

Surgeons who prepare the patient for surgery say little about anesthesia. And the main specialist in this matter - the anesthesiologist - advises and explains everything only shortly before the operation.

People are looking for information online. And here she is, to put it mildly, different. Who to believe?

Today we will talk about the types of anesthesia in the pediatric medical practice, about indications and contraindications to it, about possible consequences. And, of course, we will dispel the myths in this topic.

Many medical manipulations are very painful, so even an adult cannot bear them without anesthesia. What is there to say about the child?

Yes, exposing a child to even a simple procedure without anesthesia is a huge stress for a small organism. This can cause neurotic disorders (tics, stuttering, sleep disturbances). It is also a lifelong fear of people in white coats.

That is why, in order to avoid discomfort and reduce stress from medical procedures, painkillers are used in surgery.

Actually anesthesia is called general anesthesia. This is an artificially created, controlled state in which there is no consciousness and no reaction to pain. At the same time, vital important features body (breathing, heart function).

Modern anesthesiology has advanced significantly over the past 20 years. Thanks to her, today it is possible to use new drugs and their combinations to suppress involuntary reflex reactions of the body and reduce muscle tone if necessary.

According to the method of conducting general anesthesia in children, it is inhalation, intravenous and intramuscular.



In pediatric practice, inhalation (hardware-mask) anesthesia is more often used. With hardware-mask anesthesia, the child receives a dose of painkillers in the form of an inhalation mixture.

This type of anesthesia is used during short, simple operations, as well as in some types of research, when a short-term shutdown of the child's consciousness is required.

Painkillers used for mask anesthesia are called inhalation anesthetics (Ftorotan, Isoflurane, Sevoflurane).

Intramuscular anesthesia for children is practically not used today, since with such anesthesia it is difficult for the anesthetist to control the duration and depth of sleep.

It has also been established that such a commonly used drug for intramuscular anesthesia, like Ketamine, is unsafe for the child's body. Therefore, intramuscular anesthesia is leaving pediatric medical practice.

For long and difficult operations, intravenous anesthesia is used or combined with inhalation anesthesia. This allows you to achieve a multicomponent pharmacological effect on the body.

Intravenous anesthesia involves the use of various medications. It uses narcotic analgesics (not drugs!), muscle relaxants that relax skeletal muscles, sleeping pills, various infusion solutions.

During the operation, the patient is given artificial lung ventilation (ALV) with a special apparatus.

Only the anesthesiologist makes the final decision on the need for this or that type of anesthesia for a particular child.

It all depends on the condition of a small patient, on the type and duration of the operation, on the presence of concomitant pathology, on the qualifications of the doctor himself.

To do this, before the operation, the anesthetist must tell the parents as much information as possible about the characteristics of the growth and development of the child.

In particular, the physician should learn from parents and/or medical records:

• How was the pregnancy and childbirth?
• what was the type of feeding: natural (up to what age) or artificial;
• what illnesses the child had;
• whether there were cases of allergies in the child himself or in the next of kin and to what exactly;
• what is the vaccination status of the child and whether any negative reactions of the body during vaccination were previously identified.

Contraindications

There are no absolute contraindications to general anesthesia.

Relative contraindications may include:

The presence of concomitant pathology, which can adversely affect the condition during anesthesia or recovery after it. For example, anomalies of the constitution, accompanied by hypertrophy of the thymus gland.

A disease accompanied by difficulty in nasal breathing. For example, due to the curvature of the nasal septum, the growth of adenoids, chronic rhinitis(for inhalation anesthesia).

Having an allergy to medications. Sometimes before the operation, the child is given allergy tests. As a result of such tests (skin or test tube tests), the doctor will have an idea of ​​which drugs the body is taking and which it gives an allergic reaction to.

Based on this, the doctor will decide in favor of using one or another drug for anesthesia.

If the child had an acute respiratory viral infection or another infection with fever the day before, then the operation is postponed until the body is fully restored (the interval between the disease and treatment under anesthesia should be at least 2 weeks).

If the child ate before the operation. Children with a full stomach are not allowed for surgery, as there is a high risk of aspiration (gastric contents entering the lungs).

If the operation cannot be delayed, then the gastric contents can be evacuated using a gastric tube.

Before the operation or the actual hospitalization, parents should conduct a psychological preparation of the child.

Hospitalization itself for a baby, even without surgery, is a difficult test. The child is frightened by separation from parents, alien environment, regime change, people in white coats.

Of course, not in all cases the child needs to talk about the upcoming anesthesia.

If the disease interferes with the child and brings him suffering, then it is necessary to explain to the baby that the operation will save him from the disease. You can explain to the child that with the help of a special children's anesthesia, he will fall asleep and wake up when everything has already been done.

Parents should always communicate that they will be with the child before and after the operation. Therefore, the baby should wake up after anesthesia and see the dearest and closest people to him.

If the child is old enough, you can explain to him what awaits him in the near future (blood test, blood pressure measurement, electrocardiogram, cleansing enema, etc.). So the child will not be scared various procedures because he didn't know about them.

The hardest thing for parents and young children is given to keep a hungry pause. I have already spoken about the risk of aspiration above.

6 hours before anesthesia, the child cannot be fed, and 4 hours before, you can not even drink water.

A breastfed baby can be applied to the breast 4 hours before the upcoming operation.

A child who is receiving formula milk should not be fed 6 hours before anesthesia.

Before the operation, the intestines of a small patient are cleaned with an enema so that during the operation there is no involuntary stool discharge. This is very important for abdominal operations (on the abdominal organs).

In children's clinics, doctors have many devices in their arsenal to divert the attention of children from upcoming procedures. These are breathing bags (masks) with images of various animals, and flavored face masks, for example, with the smell of strawberries.



There are also special children's ECG devices, in which the electrodes are decorated with the image of the muzzles of different animals.

All this helps to distract and interest the child, conduct a survey in the form of a game, and even give the child the right to choose, for example, a mask for himself.

The consequences of anesthesia for the child's body

In fact, much depends on the professionalism of the anesthesiologist. After all, it is he who selects the method of introduction into anesthesia, the necessary drug and its dosage.

In children's practice, preference is given to proven drugs with good tolerance, that is, with minimal side effects, and which are quickly excreted from the child's body.

There is always a risk of intolerance to drugs or their components, especially in children prone to allergies.

It is possible to predict this situation only if the close relatives of the child had a similar reaction. Therefore, this information is always clarified before the operation.

Below I will give the consequences of anesthesia, which can occur not only due to intolerance to medications.

• Anaphylactic shock (immediate type allergic reaction).
• Malignant hyperemia (temperature rise above 40 degrees).
• Cardiovascular or respiratory failure.
• Aspiration (reflux of stomach contents into the respiratory tract).
• Mechanical trauma is not excluded during catheterization of the veins or bladder, tracheal intubation, the introduction of a probe into the stomach.

The probability of such consequences exists, although it is extremely small (1-2%).

AT recent times there was information that anesthesia can damage the neurons of the child's brain and affect the pace of development of the baby.

In particular, it is assumed that anesthesia disrupts the processes of memorizing new information. It is difficult for a child to concentrate and learn new material.

This pattern was suggested after using injectables such as Ketamine for intramuscular anesthesia, which is practically not used in pediatric practice today. But the validity of such conclusions is still not fully proven.

Moreover, if there are such changes, they are not lifelong. Usually, cognitive abilities are restored within a few days after anesthesia.

Children after anesthesia recover much faster than adults, since metabolic processes are faster and the adaptive capabilities of a young organism are higher than in adulthood.

And here much depends not only on the professionalism of the anesthesiologist, but also on the individual characteristics of the child's body.

Young children, that is, up to two years, are at greater risk. In children at this age, the nervous system actively matures, and new neural connections are formed in the brain.

Therefore, operations under anesthesia, if possible, are postponed for a period after 2 years.

Myths about anesthesia

“What if the child does not wake up after the operation?”

World statistics say that this is extremely rare (1 out of 100,000 operations). Moreover, more often such an outcome of the operation is associated not with a reaction to anesthesia, but with the risks of the surgical intervention itself.

It is in order to minimize such risks that the patient undergoes a thorough examination during elective operations. If any disorders or diseases are detected, the operation is postponed until the complete recovery of the small patient.



“What if the child feels everything?”

Firstly, no one calculates the dosage of anesthetics for anesthesia "by eye". Everything is calculated based on the individual parameters of a small patient (weight, height).

Secondly, during the operation, the child's condition is constantly monitored.

The pulse, respiratory rate, blood pressure and body temperature of the patient, the level of oxygen / carbon dioxide in the blood (saturation) are tracked.

In modern clinics with good operating equipment, you can even track the depth of anesthesia, the degree of relaxation skeletal muscles patient. This allows you to accurately track the minimum deviations in the child's condition during the operation.



“Mask anesthesia is an outdated technique. A safer form of anesthesia intravenous "

Most operations (more than 50%) in pediatric practice are performed using inhalation (hardware-mask) anesthesia.

This type of anesthesia eliminates the need for the use of potent drugs and their complex combinations, unlike intravenous anesthesia.

At the same time, inhalation anesthesia gives the anesthesiologist more room for maneuver and allows better management and control of the depth of anesthesia.

In any case, regardless of the reasons for which the operation with anesthesia is indicated for the child, anesthesia is a necessity.

This is a savior, an assistant who will allow you to get rid of the disease in a painless way.

Indeed, even with minimal intervention under local anesthesia, when the child sees everything, but does not feel, the psyche of not every child can withstand this “spectacle”.

Anesthesia allows the treatment of non-contact and low-contact children. Provides comfortable conditions for the patient and the doctor, reduces the time of treatment and improves its quality.

Moreover, not in all cases we have the opportunity to wait, even if the child is small.

In this case, doctors try to explain to parents that leaving the child’s illness without surgical treatment can provoke greater consequences than the likelihood of developing temporary consequences of general anesthesia.

What is the danger of general anesthesia for a child, you were told by a practicing pediatrician and twice mother Elena Borisova-Tsarenok.

Majority holding surgical operations today is unthinkable without adequate anesthesia. Despite the fact that general anesthesia has been successfully used in pediatrics for a long time, parents are scared by the prospect of its administration to a small baby - they are scared possible dangers and complications after surgery, she is concerned about the consequences for the child. Parents should be aware of the intricacies of the procedure and contraindications to it.

Some manipulations with a child cannot be performed without general anesthesia

General anesthesia- this is special condition organism, in which, under the influence of special drugs, the patient falls into sleep, there is total loss consciousness and loss of sensitivity. Children do not tolerate any medical manipulations well, therefore, during serious operations, it is necessary to “turn off” the baby’s consciousness so that he does not feel pain and does not remember what is happening - all this can cause severe stress. Anesthesia is also needed by the doctor - diverting attention to the reaction of the child can lead to errors and serious complications.

The child's body has its own physiological and anatomical features - the ratio of height, weight and body surface area changes significantly as they grow older. It is advisable for children under three years of age to administer the first drugs in a familiar environment and in the presence of their parents. It is preferable to carry out induction anesthesia at this age with the help of a special toy mask, diverting attention from unpleasant sensations.



Carrying out mask anesthesia for a child

As he grows older, the baby tolerates manipulations more calmly - a child of 5-6 years old can be involved in induction anesthesia - for example, offer the child to hold the mask with his hands or blow into the anesthesia mask - after exhalation, it will follow deep breath drug. It is important to choose the right dosage of the drug, since the child's body reacts sensitively to exceeding the dose - the likelihood of complications in the form of respiratory depression and overdose increases.

Preparation for anesthesia and necessary tests

General anesthesia requires parents to carefully prepare the baby. It is necessary to examine the child in advance and pass the necessary tests. Typically required general analysis blood and urine tests, coagulation system examination, ECG, pediatrician's conclusion about the general state of health. On the eve of the operation, a consultation with an anesthesiologist is required, who will perform general anesthesia. The specialist will examine the child, clarify the absence of contraindications, find out the exact body weight for calculation the right dosage and answer any questions parents may have. It is important to make sure that there is no runny nose - nasal congestion is a contraindication to anesthesia. Another important contraindication to anesthesia is fever for unknown reasons.



Before general anesthesia, the child should be examined by doctors

The stomach of the baby during anesthesia should be completely empty. Vomiting during general anesthesia is dangerous - children have very narrow airways, so the likelihood of complications in the form of aspiration of vomit is very high. Newborns and infants under one year of age receive the last breast 4 hours before surgery. Children under 1 year of age, who are bottle-fed, maintain a hungry pause of 6 hours. Children over 5 years of age take their last meal the night before, and it is contraindicated to drink plain water 4 hours before anesthesia.

How is anesthesia performed in childhood

The anesthesiologist always tries to minimize the discomfort from anesthesia for the child. To do this, premedication is performed before the operation - the baby is offered sedatives relieving anxiety and fear. Children under the age of three or four are already in the ward receiving drugs that put them in a state of half sleep and complete relaxation. Small children under 5 years of age are very painful to part with their parents, so it is advisable to be with the child before he falls asleep.

Children older than 6 years of age usually tolerate anesthesia well and arrive in the operating room conscious. The doctor brings a transparent mask to the child's face, through which oxygen and a special gas are supplied, causing anesthesia for children. As a rule, the child falls asleep within a minute after the first deep breath.



Introduction to anesthesia occurs in different ways depending on the age of the child.

After falling asleep, the doctor regulates the depth of anesthesia and carefully monitors vital signs - measures blood pressure, monitors the condition of the child's skin, evaluates the work of the heart. In the case when general anesthesia is performed on an infant up to a year old, it is important to prevent excessive cooling or overheating of the baby.

Anesthesia for children under one year old

Most doctors try to delay the moment of introducing general anesthesia to the baby up to a year as far as possible. This is due to the fact that in the first months of life there is an active development of most organs and systems (including the brain), which at this stage are vulnerable to adverse factors.



General anesthesia for a 1 year old child

But in case of urgent need, anesthesia is also done at this age - anesthesia will do less harm than the absence of the necessary treatment. The greatest difficulties in children under one year old are associated with observing a hungry pause. According to statistics, infants under one year of age tolerate anesthesia well.

Consequences and complications of anesthesia for children

General anesthesia is a rather serious procedure that carries a certain risk of complications and consequences, even when taking into account contraindications. It is believed that anesthesia can damage neuronal connections in the brain, contributes to an increase in intracranial. At risk for the occurrence of unpleasant consequences are children under 2-3 years of age and younger, especially those with diseases nervous system. However, it should be noted that such symptoms in most cases developed with the introduction of outdated anesthetics, and modern anesthetics have minimal side effects. In most cases unpleasant symptoms disappeared shortly after the operation.



Children under 2-3 years of age are the most difficult to tolerate anesthesia

Of the possible complications, the most dangerous is the development anaphylactic shock, which occurs when you are allergic to the administered drug. Aspiration of gastric contents is a complication that occurs more often in emergency operations when there was no time for appropriate preparation.

It is very important to choose a competent anesthesiologist who will evaluate contraindications, minimize the risks of developing unpleasant consequences, choose the right drug and its dosage, and also quickly take action in case of complications.