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Important information about anesthesia in children. Consequences of general anesthesia for a child How general anesthesia affects a child

General anesthesia used in children can have many consequences. The child's body grows and develops very quickly, and any interference with the central nervous system can negatively affect the child's development. This article discusses the main complications that can develop after surgical interventions using general anesthesia.

General anesthesia

General anesthesia is a condition deep sleep, which is caused by medications. Thanks to anesthesia, doctors have the opportunity to perform long and complex operations. This is especially significant in pediatric surgery, because now children who are born with severe malformations of the cardiovascular system and other abnormalities have a chance to live.

But anesthesia itself is not a harmless procedure. Recently, doctors have conducted a lot of research on its complications and consequences. A special place in their work was given to the influence of general anesthesia on children. Speaking about adults, allergic reactions to injected drugs and complications from the heart are more relevant; in the case of children, problems associated with slow development and disruption of the central nervous system come to the fore.

Drugs used for general anesthesia in children under three years of age can affect the development and formation of nerve connections between neurons in the brain and the processes of myelination of nerves (formation of a sheath around a nerve fiber). These changes in the central nervous system are the causes of negative consequences in the development of the child. When deciding on an operation, the doctor must always weigh the need for it with the harm to the child’s body.

Early complications of general anesthesia

This group of complications is not much different from the same in adults. They usually develop while the child is under anesthesia, or in a short period after it. These complications are caused by the direct effect of the drug on the child’s body. These include:

  • Allergic reactions: anaphylactic shock, Quincke's edema.
  • Stupor, coma.
  • Heart rhythm disturbances, in the form of atrioventricular arrhythmia, His bundle block.

Anesthesiologists must cope with these acute and dangerous complications. Fortunately, they occur quite rarely.

The anesthesiologist constantly monitors the patient's condition during anesthesia

Late complications after anesthesia in children

Even if the operation was successful, without complications, and there was no reaction to the anesthetic, this does not guarantee that there was no negative effect on the child’s body. Long-term consequences do not appear immediately. They can become noticeable even after a few years.

TO late complications include:

  1. Cognitive disorders and attention deficit hyperactivity disorder are described in detail below.
  2. Chronic and frequent headaches, sometimes in the form of migraines. The occurrence of a headache is usually not associated with any triggering factors. The whole head may hurt, or half of it. The pain is practically not relieved by analgesics.
  3. Sluggish disturbances in the liver and kidneys.
  4. Frequent dizziness.
  5. Leg muscle cramps.

Cognitive disorders develop most often. These include:

  • Memory disorders in children. It may be difficult to remember educational material. For example, children may find it difficult to teach foreign languages, poetry. Memory can also be impaired for other reasons, for example, due to a lack of iodine in the body.

It is difficult for a child to remember new material

  • Violation logical thinking. It is difficult for children to draw conclusions and look for connections between events.
  • Difficulty concentrating on one thing. Such children do not like to read books, they find it difficult at school. Usually during training they are distracted and talk. And parents punish and scold them, instead of understanding the reason for the child’s behavior.

In addition to cognitive disorders, anesthesia is dangerous due to the possibility of developing attention deficit hyperactivity disorder. It is manifested by impulsive behavior, impaired attention of the baby and hyperactivity. Such children cannot predict the consequences of their actions, which is why they are frequent guests of trauma centers. They find it difficult to complete any task or adhere to the rules of the game. Hyperactivity is manifested by difficulty sitting in one place for a long time. During lessons they fidget, turn from side to side, chat with classmates.

Hyperactive child

Consequences in young children

The central system in children under three years of age develops very quickly. And at three years the brain weight is almost the same as that of an adult. Any interventions at this age may entail severe consequences. General anesthesia at this age is especially harmful and dangerous.

In addition to attention deficit disorder and cognitive disorders, it can cause harm in the formation of nerve pathways and fibers, connections between parts of the brain, which can lead to the following consequences:

  1. Lag in physical development. The drugs can harm the parathyroid gland, which is responsible for the growth of the child. Such children may be delayed in growth, but as a rule, they later catch up with their peers.
  2. Slowing of psychomotor development. Children who have undergone general anesthesia may find it difficult to learn to read, remember numbers, pronounce words correctly, and construct sentences.
  3. Epilepsy. This complication is quite rare, but clinical cases have been described in which this disease started after surgical interventions.

Is it possible to prevent the development of complications?

It is difficult to say whether there will be a complication, when and how it will appear. But you can try to reduce the risk of developing negative consequences in the following ways:

  1. Carefully examine the baby’s body, if possible. During planned operations, it is better to do all the examinations suggested by the attending doctor.
  2. After surgery, use medications that will improve cerebral circulation, vitamins. A neurologist will help you select them. This could be Piracetam, Cavinton, B vitamins and others.
  3. Closely monitor the condition and development of your child. It is better to consult a doctor once again to exclude harm from anesthetics.

Having learned about the existence of all these terrible complications, you should not refuse upcoming operations. The main thing is to be attentive to the baby’s health, not to self-medicate at home, and if there is the slightest deviation in his health, go to the pediatrician.

Mikhnina A.A.

With the development of modern society, the emergence high technology and their penetration into medicine in particular, it has become popular to demand that medical procedures not only getting rid of the disease, but also a minimum of discomfort during their implementation. To eliminate pain and psychological stress associated with its anticipation, modern medicine is ready to offer us the use of anesthesia in a variety of forms - from simple local anesthesia to deep medicated sleep (anesthesia). When conducting extensive operations for treatment serious illnesses the need for anesthesia is obvious.

However, there are other situations: we want to give birth without pain, to treat our teeth without fear, and to improve our appearance without discomfort. However, there are no absolutely safe medical interventions and medications.

And here it is very important to weigh the risk against the actual need. In addition to the risk of complications from the medical procedure or exacerbation of the disease against the background of intervention in the body, it is also necessary not to forget about existing risk adverse consequences from anesthesia. It is especially important to remember this when it comes to our children, for whom we, the parents, make decisions regarding their health.

Just recently, on a parent forum, I read a message from a mother who had her 1.5-year-old child undergo surgery to cut the hyoid frenulum under general anesthesia. To be honest, I was somewhat discouraged by such frivolity - anesthesia for a child, since, in my opinion, there is absolutely no need for anesthesia for such a low-traumatic and quick procedure. This is the same as donating blood from your finger under anesthesia! Does this occur to you? At the same time, many participants in the discussion on this forum also did not see anything wrong in the described situation.

Actually, this incident served as the reason for conducting some research into the issue of the dangers of anesthesia. I began to wonder if it is as terrible and dangerous in its consequences as one sometimes hears. Can anesthesia seriously harm a child?

For help in writing this note, I turned to specialists: a surgeon highest category, Doctor of Medical Sciences, Professor, employee of the Oncology Research Institute named after. prof. N.N. Petrova Mikhnin A.E. and an anesthesiologist-resuscitator of the highest category, an employee of the intensive care unit and intensive care newborns at Children's City Hospital No. 1 in St. Petersburg, Naumov D.Yu.

What is anesthesia, and why is it necessary?
Anesthesia can be local or general. In the second case, it is customary to talk about anesthesia. With local anesthesia, the drug is injected into the tissue directly in the area of ​​conduction. medical intervention or into the nerve endings responsible for carrying pain impulses from this area and adjacent (sometimes large) areas to the brain. However, it does not have a significant effect on the body as a whole (with the exception of dangerous case allergic reaction to an analgesic). This is how we treat teeth, remove papillomas, and do piercings. Epidural or spinal anesthesia, used in childbirth, also refers to local.

General anesthesia (general anesthesia, anesthesia) is a condition caused by pharmacological agents and characterized by controlled switching off of consciousness and loss of sensitivity, suppression of reflex functions and reactions to external stimuli, which allows surgical interventions to be performed without dangerous consequences for the body and with complete amnesia during the operation. The term “general anesthesia” more fully than the term “anesthesia” reflects the essence of the state that must be achieved for safe execution surgical operation. The main thing is to eliminate the reaction to painful stimuli, and depression of consciousness is of less importance. (The common everyday expression “general anesthesia” is incorrect; the equivalent is “oil”).

Mikhnin Alexander Evgenievich:“Exactly. The main task of general anesthesia is to prevent such a dangerous state of the body as painful shock, which can lead to death. It is important to qualitatively anesthetize the patient, while he may be conscious (depending on the type of operation performed). This effect is achieved, for example, with epidural anesthesia. Another important task"Anesthesia is a complete relaxation of the muscles, facilitating access to the internal organs."

In a situation where we are talking about treating a child, the goals of using anesthesia often change priority, and the need to turn off consciousness and immobilize a small patient may come to the fore.

Mikhnin Alexander Evgenievich:“It’s all true. But, nevertheless, there is important rule, based on common sense, and which I, as a surgeon, always adhere to in relation to both adults and very young patients. Its essence is that the danger of anesthesia should not exceed the risk of the medical manipulation for which the patient is given anesthesia.”

There is an opinion that anesthesia shortens life. However, I read a lot of materials on sites medical clinics that drugs for general anesthesia and technologies for their introduction into the body have changed significantly over the past long time their practical application(ether anesthesia was first used in 1846). During clinical trials New drugs were developed, and anesthesia today has become practically safe. What should you still be wary of during general anesthesia?

Naumov Dmitry Yurievich:“Anesthesia itself, of course, does not shorten life. Otherwise, many of the patients I know would have already died from its consequences, having been cured of the underlying disease and, in fact, healthy people. The danger of anesthesia really lies, on the one hand, in the toxicity of the drugs used, which was especially important at the dawn of the era of drug anesthesia, when a wide variety of substances were used, including those dangerous for their long-term effects, the required level of analgesia and relaxation of the body was achieved due to the prolonged maintenance of highly toxic doses of the drug in the patient’s blood, and on the other hand, the risks are determined by the level of qualification of the anesthesiologist.

Most of the negative consequences of anesthesia are associated precisely with the human factor: firstly and mainly, with the characteristics of the patient’s body, which can give an unexpected reaction, and you need to be prepared to cope with it; secondly, with the qualifications of the anesthesiologist himself, when he does not know to the fullest modern technologies combined anesthesia, did not keep track of some vital parameters of the patient’s body under anesthesia or did not take the necessary measures to maintain them and correct the patient’s condition in a timely manner, did not promptly notice an allergy to some medicine used (these, of course, are criminal extremes ).

Today, modern drugs that have no long-term effects and are quickly eliminated from the body (for example, sevofluoran, remifentanil) are used for general anesthesia. Anesthesia is carried out by a combination of various substances and methods of their administration: intravenously, intramuscularly, inhalation, rectally, transnasally. The combined use of two or more drugs is carried out with the aim of reducing the dose, and, consequently, the toxicity of each of them, providing all the necessary components of anesthesia using agents with selective properties without deep violation functions of the central nervous system.

And yet we must not forget that even the most safe drugs to provide anesthesia, they have a certain toxicity to the body. It’s no coincidence that anesthesia is also called a medical coma.”

This means that there may still be some consequences from the use of anesthesia, even a modern one and carried out efficiently by a competent and experienced anesthesiologist, just like from any medical procedure. What are they, and what is the probability of getting one or another complication?

Naumov Dmitry Yurievich: “There are respiratory, cardiovascular and neurological complications of anesthesia, as well as anaphylactic shock.
TO respiratory complications include cessation of breathing during the procedure of general anesthesia (apnea) or after recovery from anesthesia after the patient’s breathing has been completely restored (recurarization), bronchiolospasm, laryngospasm.
The causes of this type of complications are very different: from mechanical injuries during the procedure of general anesthesia (trauma with a laryngoscope, rough intubation, exposure to various dust, foreign bodies and vomit into the respiratory tract, etc.) to an individual reaction to drugs and general serious condition sick. Increased risk such complications occur in persons suffering from diseases respiratory systems s. Thus, bronchiolospasm (total or partial) can occur in patients with tumors of the bronchi and lungs, bronchial asthma and those prone to allergic reactions. Laryngospasm often develops when secretions accumulate in the larynx, in particular in patients with pulmonary tuberculosis. (author's note - The frequency of such complications averages 25% (mainly as a result of regurgitation of gastric contents)(1)).
Cardiovascular complications include arrhythmias, bradycardia, and cardiac arrest. Most often they occur due to inadequate administration of general anesthesia (overdose of certain drugs), not enough prompt elimination signs of hypoxia, untimely or ineffective resuscitation measures carried out to correct the consequences of a surgical operation performed on a patient (severe irritation of reflexogenic zones, massive blood loss etc.).
A risk factor here is also the patient’s history of cardiovascular diseases. The average incidence of such complications is 1:200 cases in the risk group.
Neurological complications include seizures, muscle pain, trembling upon awakening, hyperthermia, regurgitation, vomiting. The causes of this type of complications are also a reaction to various medications used during surgery, concomitant diseases of the central nervous system (brain tumor, epilepsy, meningitis), inadequate preoperative preparation. There is a category of patients who have such unpleasant and dangerous phenomenon during anesthesia, such as vomiting, which can lead to blockage respiratory tract, bronchospasm and impaired ventilation of the lungs and hypoxia during surgery, as well as pneumonia in the postoperative period, occurs without any apparent reason.
Extremely dangerous complication during operations performed both under general anesthesia and local anesthesia, anaphylactic shock occurs, which is an individual allergic reaction of the body to medications, manifested by a sharp sudden decrease in blood pressure, disruption of the cardiovascular and respiratory systems. The allergen can be both the narcotic drugs themselves and the drugs and solutions used during surgery. Often this complication ends fatal, because anaphylactic reaction is difficult and difficult to treat, the basis of therapy is hormonal drugs. (author's note - The average incidence of such complications is 1:10,000 cases. (2))
To exclude the possibility of such a reaction of the body, the anesthesiologist must very carefully study the patient’s medical history and information about the presence of allergic reactions on medications, in particular, various anesthetics, in order to prevent their use. It is extremely important in this case that the patient himself provides reliable and complete information about yourself when answering questions asked by doctors.
It is also important to note that anesthesia affects memory. During severe anesthesia, brain function related to memory deteriorates. Sometimes irreversible."

Mikhnin Alexander Evgenievich: “For the safest possible operation and minimization of the risks associated with putting the patient under anesthesia, high-quality preoperative preparation of the patient is very important, including the correction of activity disorders various systems body, relieving exacerbations chronic diseases, adherence to diet and rest on the eve of surgery. In particular, 4-6 hours before surgery, under anesthesia, the intake of food and liquids is prohibited to eliminate the risk of vomiting. Compliance with the latter requirement largely lies on the conscience of the patient, and he must understand the seriousness of the possible consequences of its violation. Preparation for surgery can take from 1 day. up to 1-2 weeks.”

Which of the following complications can most often occur in children during anesthesia? Are there any peculiarities here in comparison with adult patients?

Naumov Dmitry Yurievich: “The specificity of the use of general anesthesia in children is associated with the characteristics child's body. Thus, newborns have reduced sensitivity to certain narcotic substances, so their concentration in the blood is sometimes required to be 30% higher compared to adult patients. This increases the likelihood of overdose and respiratory depression, and as a consequence of hypoxia. There are a number of drugs that are never used during anesthesia for children.
Oxygen is an integral part of any inhalational anesthesia. However, it is now well known that in premature infants, hyperoxygenation (use of 100% oxygen) can lead to severe vasoconstriction of the vessels of the immature retina, causing retrolental fibroplasia and blindness. In the central nervous system it leads to disruption of thermoregulation and mental functions, convulsive syndrome. In the lungs, hyperoxia causes inflammation of the airway mucosa and destruction of surfactant. The anesthesiologist must know and take into account all these features.
In childhood, the thermoregulation system is imperfect, so it is necessary special attention pay attention to maintaining a constant body temperature and avoiding both hypothermia and overheating, which can lead to a very life-threatening complication - hyperthermia (frequency this complication It is rare, approximately 1: 100,000 cases, the more dangerous it is if it suddenly occurs. Usually anesthesiologists are not prepared to face such a problem, because... I have usually never encountered it in my entire practice). Also, specific complications of general anesthesia in children include convulsions, the development of which may be associated with hypocalcemia, hypoxia, as well as subglottic laryngeal edema. In the presence of various chronic diseases, the likelihood of certain complications of anesthesia in children, as well as in adults, increases depending on the characteristics of these concomitant diseases. Everything is individual here.”

Mikhnin Alexander Evgenievich: “For elderly and pediatric patients, preparation for surgery under anesthesia must necessarily include a psychological component and complete removal of preoperative emotional stress. In such patients nervous system characterized by instability, and a high degree of psychogenic neurological disorders, which can cause complications of general anesthesia from both the central nervous system and the cardiovascular system. The constant presence and psychological support of close relatives for elderly patients and parents for child patients in the period of preparation for surgery and immediately before the administration of anesthesia is very important.”

Thus, modern anesthesia minimally toxic, highly effective and quite safe if performed by an experienced anesthesiologist. It can be performed many times without harming the patient's health, unless any complications arise. The likelihood of them in modernly equipped clinics with highly qualified staff is not so high. However, there is always room for risk associated with individual characteristics each person, as well as the insufficient qualifications of the anesthesiologist, on whom the vital functions of the patient’s body completely depend during the operation under anesthesia.

I’ll quote here from one very sensible resource onarkoze.ru: “What is the probability of death from anesthesia in the Russian Federation? It is impossible to give a definite answer to this question due to the lack of any plausible statistics. In our country, all facts of death on the operating table are carefully kept silent and hidden.”

By putting your child into a state of medicated sleep, you completely entrust his life to the anesthesiologist.

One of my friends, a cosmetologist at a prestigious clinic aesthetic medicine, who often has to deal with people who give priority to their appearance, and therefore often resort to the services of plastic surgeons, once said that, even being herself an adherent of the cult of beauty, she deeply does not understand such a frivolous willingness of people to plunge into anesthesia without vital indications. After all, there is always the possibility of not getting out of it and dying. Moreover, she determined for herself this probability of 50/50, which, of course, from a statistical point of view is an exaggeration, but from the point of view of the common sense of each of us, perhaps not. After all, life is the most valuable thing. Whether it is worth risking it without obvious necessity, even if the chance of death is one in a million, everyone decides for himself.

Links:
1. Levichev Eduard Aleksandrovich, dissertation for the degree of Ph.D. in the specialty "Anesthesiology and Reanimatology" on the topic "Prevention of regurgitation and aspiration during general anesthesia in emergency patients", 2006 - p. 137
2. Vladimir Kochkin, “Mom and Baby” magazine, No. 2, 2006

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116 thoughts on “Anesthesia for a child”

Often anesthesia scares people, sometimes even more than surgery. The biggest fear is the unknown and possible discomfort when falling asleep and waking up. Numerous conversations about how it is dangerous to health also do not set the mood for positivity. It becomes especially alarming if we are talking about 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 body?

Operations under anesthesia in children are carried out according to the same rules as in adults, taking into account age characteristics. In children, due to anatomical and physiological characteristics, more often than in adults, critical conditions, from which resuscitation and intensive care are required. However, modern medicine uses exclusively gentle means that can put adults and children into artificially induced deep sleep.

Anesthesia for children is a loss of consciousness caused by a set of special drugs. It can include many manipulations aimed at facilitating the process of falling asleep, surgical intervention, and awakening. Among the events carried out are:

    • Placement of IVs.
    • Installation of a monitoring system for blood loss compensation.
    • Prevention of the consequences of surgery.

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

      • How did the pregnancy and childbirth go?
      • what type of feeding was it: breastfeeding (for how long) or artificial feeding;
      • what was the child's illness?
      • reactions to vaccinations;
      • Do he or his immediate family have any allergies?

All this is especially important for children early age, you need to ask the anesthesiologist questions if something is unclear, and the final decision on what anesthesia or anesthesia to administer rests with the doctor!

Types of pain relief techniques used

IN medical practice There are several types of pain relief:

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

Watch its action and main stages in this video:

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

Are there any contraindications?

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

      • The presence of pathologies of various nature that can negatively affect the state during sleep and recovery.
      • If the patient has recently had an acute respiratory viral infection or other viral infection, the operation should be postponed for several weeks until full recovery body.
      • Having allergies to drugs. The doctor studies the records in the chart in detail. If it becomes clear that there is an allergy to medications, he immediately changes his tactics.
      • Health features – high fever, runny nose.

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

How to properly prepare a child for anesthesia?

By modern concepts any surgical interventions, painful procedures, diagnostic studies in children (especially young children) should be carried out under anesthesia or sedation! Young children simply do not know what is in store for them, and no premedication is needed.

Regardless of what type of anesthesia the operation is planned under, the patient is first prepared for surgery.
Groups of children by age: 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. For planned operations, all preparation can be divided into general medical and pre-anesthesia: psychological and pharmacological premedication. An obstetric history is important: how the pregnancy and childbirth went (on time or not), the child’s anthropometric data - the correspondence of body weight and height to his age, psychomotor development, visible impairments musculoskeletal system, behavioral reactions.

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, etc. The anesthesiologist, attending physician and ward nurse help and explain to the mother how to behave.

Doctors recommend not always telling your baby what is coming. The exception is cases when the illness 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 treatment will be carried out, as a result of which they will fall asleep and wake up when everything is already done and not a trace remains of the past illness.

It is advisable 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 people who are dearest and closest 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 of drugs used for anesthesia. The result of the work good specialist is the child's stay in unconscious during the period necessary for surgical intervention, and a favorable recovery from this condition after surgery.

It is rare that intolerance to drugs or their components occurs. 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 extremely rare case(only 1-2% chance) :

  • anaphylactic shock;
  • malignant hyperemia. Sharp increase temperatures up to 42-43 degrees.
  • cardiovascular failure;
  • respiratory failure;
  • aspiration. Release of stomach contents into the respiratory tract.

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

  1. the likelihood of such consequences is highest with intravenous administration of anesthesia using Ketamine. Now similar method and the drug is practically not used for children.
  2. Children under two years of age are at greater risk. Therefore, operations under anesthesia are, if possible, postponed until after 2 years.
  3. The validity of the conclusions that only a few studies have made has not been conclusively proven.
  4. These symptoms go away quite quickly, and operations are performed in connection with real problems with the child’s health. It turns out that the need for anesthesia exceeds the possible temporary consequences of it.

Parents must understand that the condition of their baby throughout the entire operation and for 2 hours after it is monitored by modern medical equipment and personnel. Even if some consequences arise, he will be provided with the necessary assistance in a timely manner.

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

In modern medicine, pain relief is a gentle tactical means, the use of which during surgery is a necessity.

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

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

Questions on the topic

    Tatyana 10/16/2018 09:43

    Good afternoon. On October 1, we performed surgery to remove the adenoids under general anesthesia. At first, my 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 that perhaps there was vinegar evaporation, or the smell of onions (complaints in the kitchen). Then this repeated more often after waking up. Either it opens well, or the eyes could not stand to be open. And this is not only in the sun but also in the shade. Today she couldn't open her eyes completely. Has difficulty blinking or eyes are closed completely. Could this be a consequence of anesthesia? And what can be done?

    Valentina 09.17.2018 20:37

    Good evening! My son is 4 years and 9 months old, he broke his arm, fractured two bones, one bone was displaced. On the day of the fracture, general anesthesia was given on September 11, one bone was straightened, the second remained fractured and displaced. A week later, on September 19, re-administration under general anesthesia. Please give me some advice, is this very dangerous? What are the consequences?

    Olga 08/27/2018 18:33

    Good afternoon. The child had his first operation in March and a second one in early August. In both cases, general anesthesia was used. After the first operation, there was a slight weight gain, but we cannot lose 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) became not only tearful and nervous, but he developed strange psychoses: for example, he demands to walk from home to the bus stop again and come back only because his mother did not give him a hand, or she got out of the house first, and did not let him out. Or suddenly he demands in the middle of the night to feed his little sister cucumber and cries loudly, hysterically, until he gets his way... We are at a loss. We don't know what to do. We thought that he was just having whims, but it turns out that general anesthesia has a very bad effect on the child’s psyche. What should we do now? How to treat it? Help please!!! Sincerely, Evgenia Grosh

    Vladislav 06/07/2018 12:26

    Hello. My mother went through a very “quick” birth with me, my head was half blue. At the age of six, in 1994, to the surprise of my mother and doctors, I developed acute stage hemorrhoids. In the hospital I had three operations under general anesthesia, and a year later two more operations, also under general anesthesia. At the age of 12, I had a knee injury and was put under general anesthesia again. Now I'm 29 years old. From about the age of 7 until I was 20, I constantly suffered from headaches and low pressure. Now my head hurts very rarely, but I understand that weakness and drowsiness are my enemies for life. Also, during regular medical examinations from work every year, I see a diagnosis of “bradycardia”. Is my state of endless weakness a consequence of 6 general anesthetics in childhood?

    Alexander 05/28/2018 11:05

    Hello, the child is 10 years old. When falling from a height, I hit my head and received a moderate (or severe, I don’t know exactly) concussion. (there was a short-term loss of consciousness for about 30-60 seconds), memory loss (he doesn’t remember what happened immediately before the fall and the fall itself), also broke his forearm (both radial bones). The traumatology department immediately applied a plaster cast, but a repeat x-ray 1 day later revealed that the displacement remained. Doctors say it is necessary to do general anesthesia and combine the bone. Question: Isn’t 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 very small and is able to sit quietly)? Thanks in advance for your answer!

    Inna 04/19/2018 17:10

    Hello. Dear doctor, please tell me - my son (7 years old) had an operation to remove appendicitis (with peritonitis) in February. She is now undergoing surgery to remove two hernias (umbilical and linea alba). How dangerous is it to do general anesthesia after such a short period of time? THANK YOU!

    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 third cranial nerves on the left, partial ptosis upper eyelid on the left, ophthalmoplegia), but they were sick, the child had snot. Can I undergo an MRI immediately after recovery or do I need to wait some time? And one more question: I will be under general anesthesia. How dangerous is this for a child?

    Elena 03/31/2018 20:54

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

    Anastasia 03/27/2018 21:28

    Hello. Please advise what consequences may occur after anesthesia, is it worth having surgery now, or is it better to wait until 2 years? Situation: the baby is 4 months old, we have polydactyly, the 6th finger (2 on the thumb). At what age is it better to have surgery, because now the (big) finger is growing and is becoming uneven due to the second...?

    Natalya 03/27/2018 07:38

    Hello. Tomorrow my 6-year-old son will undergo treatment and teeth extraction under mask anesthesia. The anesthesiologist said that there should be no sniffles for 21 days. what does this have to do with? I understand that ARVI should not be suffered, but what about sniffles if they are dry indoors in the morning?

    Lily 03/02/2018 14:50

    hello doctor! The child is 5 years old; on Monday, March 5, he will undergo a planned operation to remove a nevus on his thigh. the child was born premature at 33-34 weeks, of course there was hypoxia and slight cerebral edema, and was on a ventilator. Before the age of one year, hydrocephalic syndrome was identified, which was treated with diacarb. at 1 year and 4 months they received a head injury, were in the hospital, after that epilepsy (absence seizures) was in question, but the doctors themselves do not know whether it is or not, who says that it is, who is not. Now, according to my observations, everything is calm. At the moment there is a minor anomaly in the development of the heart. before the operation, a general blood test was done as expected, all indicators were normal, but NEU was reduced 34.2% with a norm of 40.0-75.0, LYM was increased 41.6% with a norm of 2.01-40.0, MON was increased 9.6% with a norm of 3.0-7.0, EO was increased 13.1 % ! at a rate of 0.0-5.0. Please tell me: 1 Is it possible to perform general anesthesia in our case? 2 do they do an ECG and allergy tests for anesthesia before surgery? 3 what anesthesia is used everywhere when removing nevi?

    Natalya 01/16/2018 00:25

    Hello doctor. Please tell me how to prepare a child 1.9 for surgery? There is an allergy, not defined to what exactly, but it happens less often now. The operation is due in two months, breastfeeding is still present, mainly at night, the question is: should wean the child now from the breast or after the operation, will breastfeeding help or harm during the operation? Thanks in advance for your answer.

    Victoria 12.12.2017 13:50

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

    Marina 11.28.2017 22:48

    Hello! We are scheduled for a planned operation on the palate (cleft of the hard soft palate) in 6 days, on the other side of the country. We waited our turn for a long time - 6 months, passed all the examinations - everything was fine. But the child caught the virus: The snot is runny and he coughs. Tell me, is this a contraindication for surgery? Or is it possible to give antibiotics for a couple of days and go for surgery? Is it possible to have surgery/anesthesia with snot if we don’t 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 prescribed an operation (general anesthesia), 10 days later the operation was done, but we caught a cold, they prescribed us the antibiotic cephalexin. Are there any contraindications to general anesthesia after using it? It won’t be a big deal if we take it and go to bed for the operation

    Julia 11/13/2017 20:01

    Dear doctor, please tell me. Treatment of 2 front teeth for my son, age 1, 10 months, after an impact, gumboil formed on the gums. Treatment options are possible both with and without anesthesia. Conduct under intravenous anesthesia so as not to traumatize the child’s psyche, or treat despite fear - but refraining from anesthesia? Is it right 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 years old an operation was performed to remove an inguinal-scrotal hernia, at 1.5 years old there was a relapse (they operated on at 1.9 years old), now there is a recurrence again, there will be an operation again 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 have a circumcision, they will probably do it under anesthesia, please tell me whether at this age it is worth subjecting the body of a small child to anesthesia, or if there is no need to wait until he grows up?

    Antonina 01.11.2017 22:14

    Hello. My daughter is exactly 2 years old. An inguinal hernia was discovered on the right. There is an operation coming up. We cannot decide between laparoscopy and the abdominal method. The surgeon said that in the first case the anesthesia will last 30-40 minutes, and in the second 10 minutes. Tell me, is a difference of 20-30 minutes under anesthesia as harmful as the doctor claims? The first method is more gentle, and the postoperative period is easier, we see only advantages. The child is capricious and very active, so we don’t want an abdominal cavity. The only thing that hinders the choice of laparoscopy is this difference in time under anesthesia. Thank you.

    Yulia Prokhorova 10/19/2017 16:53

    Hello, we were diagnosed with an inguinal hernia at 2 months old, now our daughter is 6 months old. We are advised to wait up to a year with the operation, but we don’t have the strength to wait and suffer, the child is trying to crawl and the hernia is protruding. We, parents, are afraid that an incarceration could happen at any moment . The baby's tests are good (blood and urine), she is mobile and develops on time, she was born at 39 weeks with hypoxia, Apgar score is 7-8 points, diagnosis perinatal lesion Central nervous system of hypoxic-inchemic origin, PVK on the right stage 1-2, pseudocyst of the left choroid plexus. reaction to vaccination against pneumococcus - temperature 38°C. Is surgery with such diagnoses possible at 6 months? What tests should I take? If so, what kind of anesthesia and what consequences might arise? Thank you very much for your answer.

    Evgeniya 10/17/2017 18:57

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

    Olga 08/13/2017 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 really possible that often?

    Olga 08/09/2017 15:46

    The child is 1.10 months old and will undergo surgery under general anesthesia. Diagnosis of stenosing ligamentitis of the 1st part of the left hand. Question: what kind of anesthesia is given to children at this age and is there any point in waiting until they are 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 my daughter is registered with a neurologist (absence seizures), then the hospital asked for a conclusion from a neurologist that general anesthesia can be done. A neurologist does not give an opinion without an examination in a hospital, where an MRI must be done under anesthesia. And it turns out to be a vicious circle. Is it possible to do an MRI under general anesthesia for adenoids?

    Marina 08/05/2017 20:03

    Hello! My child is 5 years old, she broke 2 bones in her arm with displacement, they tried to straighten it under intravenous anesthesia, but it didn’t work. The needles were inserted under general anesthesia; after 1.5 months the needles were removed under anesthesia. Six months later, the arm was again fractured with bleeding, it was set under anesthesia, after 2 weeks the picture shows displacement, the orthopedist suggests setting the bone again under anesthesia. Is it dangerous for the body to administer anesthesia so frequently 5 times in six months? What are the consequences?

    Love 07/13/2017 11:48

    Hello, doctor! My grandson had a papilloma removed from his cheek two days ago. They did it under mask anesthesia, the whole procedure took about 20 minutes, I came to my senses quickly and easily. The wound is tiny. They were supposed to discharge him tomorrow, but my daughter wrote a refusal and took him away today, because... There are many patients, every day they were transferred from ward to ward. He developed a fever and vomited twice. Is this a consequence of anesthesia? No one in our family had any allergies or drug intolerances.

    Natalia 07/05/2017 19:00

    Good afternoon My son is 1.2. A month ago on the back closer to right shoulder blade I discovered a lump (not hard, painless, not growing). 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 malignant tumor. Is it possible to somehow determine what kind of cells these are before surgery? The child is only a year old, anesthesia scares me twice. Before the operation, CT scan under anesthesia and again during the operation under anesthesia. Is there a chance that the formation will resolve? It appeared suddenly and immediately measuring 2*3 cm.

    Ekaterina 06/22/2017 00:51

    Hello doctor! My son is 10 years old. On next week I am undergoing a planned operation to remove an inguinal-scrotal hernia. 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 of the right bundle branch. Is it even possible to use general anesthesia for such an ECG? Unfortunately in our city we don’t have pediatric cardiologist. In advance Thanks a lot for the answer!

    Evgenia 06/14/2017 12:21

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

    Natalya 05/24/2017 13:45

    Hello. My child is 2.5 months old. A cystoscopy under general anesthesia is required. A week ago, a runny nose appeared, aquamaris and saline solution were dripped, the snot did not go away within a week. When he sucks through his nose he breathes normally, but 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 nine-month-old child will undergo surgery with anesthesia. The diagnosis is hypospadias. The child has had a runny nose for the last few days. Rinsing and putting drops in the nose did not improve the situation significantly. Is it possible to give anesthesia for a runny nose or is it better to postpone the operation?

    Christina 05/09/2017 08:07

    Hello, dear doctor. I have this question. Child 1.7 will undergo surgery for craniostenosis. I'm sooooo worried about long-term anesthesia. Since we were born at 30 weeks and at birth there was a diagnosis of PPCNSL of hypoxic-ischemic origin. From birth to this day, the child was treated so that there was no lag in psychomotor development. And now I have to go through my first long-term anesthesia. Tell me what to do next so that the anesthesia does not affect psychomotor and speech development, does not cause a delay or stop speaking altogether?

    Victoria 05/08/2017 00:41

    Hello, doctor! We really need your opinion! My child is 5 years old and is diagnosed with grade 2-3 adenoids. He sleeps with his mouth open, does not snore, his mouth is also periodically open during the day, and he gets colds every month. They suggest surgery, but they didn’t ask about the child’s characteristics. We have minor cardiac anomalies, a functioning oval window of 2mm. , the cardiogram is normal, we are seeing a neurologist (sent him for an encephalogram), there were complications during childbirth: asphyxia, a constant bluish color of the bridge of the nose and nasolabial triangle, also an allergy to washing powder and some types of medications. About two months ago I had otitis media. The adenoids were checked two weeks after the 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 should I give up altogether and wait it out?

    Anna 04/20/2017 12:39

    Hello! My daughter is 4 years old, she needs to have an SCT scan of her nose and sinuses, but she refuses to lie down! What tests need to be done for anesthesia?

    Ekaterina 04/20/2017 10:20

    Hello, the child is one year and 5 months old. We were diagnosed with ataxia. I want to do an MRI of the brain so that I can clearly understand the whole picture of what ataxia is, so that the correct treatment can be prescribed. But the neurologist and osteopath advise that anesthesia is very dangerous. What do you think? Is there a risk of performing an MRI under general anesthesia for ataxia?

    Anastasia 04/05/2017 19:39

    Dear doctor, my 1.5 year old son was diagnosed with an inguinal hernia a month and a half ago, the surgeon scheduled him for a planned operation to remove it, general anesthesia is scary, the doctor says it is more dangerous not to have the 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. A tumor was discovered in the back of the upper thigh. According to the ultrasound, the fibroids measure 40 mm by 20 mm. Doesn't bother me at all, doesn't hurt. The uzologist advises not to operate, as he claims that this benign education, surgeon - to operate... What do you say? I am very afraid of surgery, especially anesthesia, I am afraid of any complications... anything can happen... What anesthesia is acceptable in our case? Thanks in advance!

    Svetlana 03/25/2017 12:40

    Hello, doctor. Daughter is 10 months old. On Tuesday, March 21, the child underwent surgery to remove a hemangioma (cutaneous-subcutaneous, diameter 5 cm) on his back. They were indubated because the operation was performed in a lateral position. On Wednesday morning, after the dressing was done, the attending physician said that he would not prescribe her for now, since the babies may have long-term reactions to the anesthesia, and there is still swelling on the wound. On Wednesday at 6 o'clock in the evening the child began vomiting, which persisted after the injection of cerucal, by night the temperature rose above 39, they brought it down with analgin and diphenhydramine, it only dropped to 38, and by the morning it began to rise. There was no vomiting on Thursday. There was no diarrhea, there was loose stool once or twice a day. Please tell me, is such a reaction really possible a day after the operation? With the permission of the doctors, I fed the child the usual diet, that is, porridge, vegetable, meat and fruit purees, although canned, industrial production. At home I supplemented with expressed breast milk, but in the hospital it was not possible to express, so I supplemented with Nan1 formula. Before the operation, we treated dysbacteriosis (Klebsiella, Staphylococcus aureus) for 8 months. The analysis before the operation was normal (Klebsiella was within normal limits, no staphylococcus was detected). Have you encountered such cases in your practice? Or is it an intestinal infection, or poor-quality puree, or teeth (only 1 has grown, the second is swollen), or a reaction to medications, or did everything coincide and was aggravated by the operation? Now the child has no vomiting or fever; he was given intravenous drips with glucose and Ringer's solution for three days, and yesterday he was given intravenous ceftreaxone once. I give Acipol with water. I started eating it myself last night - oatmeal with water and a small amount of breast milk. In the morning I had loose stools once.

    Alexandra 03/21/2017 12:51

    Hello, in January 2017, my son (6 years old) had an operation with general anesthesia. In May, he was scheduled for another operation with general anesthesia for a different diagnosis. Is the gap between anesthesia too short and how to minimize the consequences of the complication.

    Angela 03/15/2017 16:55

    Hello, my 9-year-old daughter has a lump on her foot under her toe, the granuloma is in doubt, we are going to cut it out. The doctor wants to do general anesthesia, but I doubt its necessity, is it possible to do local anesthesia?

    Natalya 03/09/2017 04:47

    Hello. My child had 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. Her condition was sluggish. Now the third day after the procedure. Very capricious. Not so active. Which I didn’t like So this is crying for no reason, strong, bending and rolling his eyes up. True, this happened twice in a day. We are 5 months old, we are injecting antibiotics. Tomorrow is a round. But I would like to read your answer. I think we can’t do without a neurologist.

    Irina 03/03/2017 12:50

    Good afternoon Three days ago, the child had his teeth treated under general anesthesia (intramuscular injection). We are treating this for the third time. The teeth were rapidly deteriorating. Eight teeth were treated at once; the volume of destruction was large. The child was not given to the doctors under any pretext, so they used anesthesia. This time there were two removals and two fillings. The teeth that were removed were practically absent, so again, anesthesia was required. For two nights now the child has been waking up and screaming, for a short time, but very emotionally. During the day I am also overly excitable and anxious. Please tell me whether we should contact doctors about this problem or whether it is a consequence of stress and over time the situation will normalize. Thank you in advance

    Nadezhda 03/03/2017 06:05

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

    27.02.2017 14:27

    Sergey, in the hands of an experienced pediatric anesthesiologist everything will go well. The child needs to be examined; anesthesia will not have any significant side effects.

    Kirill 02/22/2017 10:37

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

    Tatyana 02/19/2017 00:04

    Hello! A 4-year-old child has residual encephalopathy with delayed psycho-speech development. We want to treat and remove teeth under general ketamine anesthesia. There are also allergies in the form of rashes to some drugs. They said that it is possible that 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 give such anesthesia to an allergic person? Will anesthesia have an impact on the child’s development, which is already lagging behind? Thank you.

    Zebo 02/12/2017 15:09

    Hello. A 5-month-old child is scheduled for surgery under anesthesia. They will operate on his arm because he was born with a constriction of the left forearm. And his leukocytes are 12.9. Why is this dangerous?

    Angelina 01/27/2017 09:41

    Dear doctor, hello. My daughter is 16 years old and will undergo ENT surgery. 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 comes to his senses “easier”. I really doubt whether something like this exists in medicine. Please help me figure it out.

    Ulyana 01/24/2017 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 is it prohibited to perform an operation under anesthesia? Thanks in advance.

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 surgery for your baby. What do you need to know about anesthesia? Anesthesia, or general anesthesia - this is a time-limited medicinal effect on the body, in which the patient is in an unconscious state when painkillers are administered to him, with the subsequent restoration of consciousness, without pain in the area of ​​​​the operation. Anesthesia may include giving the patient artificial respiration, ensuring muscle relaxation, placing IVs to maintain consistency internal environment the body using 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 “wake up” after the operation without experiencing a state of discomfort.

Species anesthesia

Depending on the method anesthesia There are inhalation, intravenous and intramuscular. Choosing a 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 surgeon, etc., because different general anesthesia may be prescribed for the same operation. The anesthesiologist can mix different types anesthesia, achieving the ideal combination for a given patient. Anesthesia is conventionally divided into “small” and “large”, it all depends on the number and combination of drugs various groups. To the "little ones" anesthesia can be classified as inhalation (hardware-mask) anesthesia and intramuscular anesthesia. With hardware-mask anesthesia child receives an anesthetic drug in the form of an inhalation mixture while breathing independently. Painkillers administered into the body by inhalation 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 studies when short-term switching off of consciousness is necessary baby. Currently inhaled anesthesia most often combined with local (regional) anesthesia, since in the form of mono anesthesia not effective enough. Intramuscular anesthesia Nowadays 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 anesthesiologist is absolutely unable to manage. In addition, a drug that is mainly used for intramuscular anesthesia - KETAMINE, according to the latest data, is not so harmless for the patient, it turns off long-term memory for a long period (almost six months), interfering with the full development baby. "Big" anesthesia 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 by inhalation through the lungs. The patient undergoes artificial pulmonary ventilation (ALV) during the operation.

Some terminology

Premedication- psycho-emotional and medicinal preparation of the patient for the upcoming operation, begins several days before surgery and ends immediately before the operation. The main task of premedication is to relieve fear, reduce the risk of developing allergic reactions, prepare the body for upcoming stress, calm baby. Medicines can be administered orally in the form of syrup, as a nasal spray, intramuscularly, intravenously, and also in the form of microenemas. Vein catheterization- placing a catheter in the peripheral or central vein for repeated administration of intravenous medications during surgery. This manipulation is performed before surgery. Artificial ventilation(ventilator) - a method of delivering oxygen to the lungs and further to all tissues of the body using an artificial ventilation device. During surgery, mechanical ventilation begins immediately after the administration of muscle relaxants - drugs that temporarily relax skeletal muscles, which is necessary for intubation. Intubation- insertion of an endotracheal tube into the lumen of the trachea for artificial ventilation of the lungs during surgery. This manipulation by the anesthesiologist is aimed at ensuring the delivery of oxygen to the lungs and protecting the patient's airways. Infusion therapy- intravenous administration of sterile solutions to maintain a constant water-electrolyte balance in the body, the volume of circulating blood through the vessels, to reduce the consequences of surgical blood loss. Transfusion therapy- intravenous administration of drugs made from the patient’s blood or donor’s blood (packed red blood cells, fresh frozen plasma, etc.) to compensate for irreplaceable blood loss. Transfusion therapy is in itself an operation for the forced introduction of foreign matter into the body, and is used according to strict life-saving indications. Regional (local) anesthesia- a method of anesthetizing a specific area of ​​the body by applying a solution of local anesthetic (painkiller) to large nerve trunks. One of the options for regional anesthesia is epidural anesthesia, when a local anesthetic solution is injected into the paravertebral space. This is one of the most technically difficult manipulations in anesthesiology. The simplest and most famous local anesthetics are NOVOCAINE And LIDOCAINE, and modern, safe and having the longest effect - ROPIVACAIN.

Are there any contraindications?

Contraindications to anesthesia no, except for the refusal of the patient or his relatives anesthesia. However, many surgical interventions can be performed without anesthesia, under local anesthesia (pain relief). But when we talk about the patient’s comfortable condition during surgery, 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 it's not at all necessary anesthesia in children it is used only during operations. Anesthesia may be required for a variety of diagnostic and therapeutic measures, where it is necessary to remove anxiety, turn off consciousness, enable the child not to remember unpleasant sensations, about the absence of parents, about a forced long-term position, about a dentist with shiny instruments and a drill. Wherever you need peace of mind baby, we need an anesthesiologist - a doctor whose task is to protect the patient from surgical stress. Before a planned operation, it is important to take into account the following point: if you baby If there is a concomitant pathology, it is desirable that the disease is not exacerbated. If 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, as the risk increases significantly postoperative complications and during the operation, breathing problems may arise, because respiratory infection primarily affects the respiratory tract. Before the operation, the anesthesiologist will definitely talk with you about topics abstract from the operation: where you were born child how you were born, whether you were vaccinated and when, how you grew up, how you developed, what illnesses you had, are there any allergies, will examine baby, get acquainted with the medical history, carefully study all the tests. He will tell you what will happen to your child before the operation, during the operation and in the immediate postoperative period.

Preparing the child for anesthesia

The most important thing is emotional sphere. It is not always necessary to tell your child about the upcoming operation. The exception is when the disease interferes with the child and he consciously wants to get rid of it. The most unpleasant thing for parents is the hunger pause, i.e. six hours before anesthesia can't feed baby, in four hours you cannot even give water to drink, and by water we mean a transparent, non-carbonated liquid without odor or taste. A newborn who is on breastfeeding, you can feed the last time four hours before anesthesia, and for baby located on artificial feeding, this period is extended to six hours. A fasting pause will help avoid such complications during the onset of anesthesia, like aspiration, i.e., the entry of stomach contents into the respiratory tract (this will be discussed later). Should I do an enema before surgery or not? The patient's intestines must be emptied before surgery so that during surgery, under the influence of anesthesia there was no involuntary passage of stool. Moreover, this condition must be observed during operations on the intestines. Typically, three days before surgery, the patient is prescribed a diet that excludes meat products and foods containing plant fiber, sometimes a laxative is added to this the day before the operation. In this case, an enema is not needed unless the surgeon requires it. The anesthesiologist has many distraction devices at his disposal. baby from the upcoming anesthesia. This and breathing bags with images of different animals, and face masks with the smell of strawberries and oranges, this ECG electrodes with images of cute faces of your favorite animals - that is, everything for a comfortable sleep baby. But still, parents should stay with the child until he falls asleep. And the baby should wake up next to his parents (if child is not transferred after surgery to the intensive care unit).

During surgery

After child fell asleep anesthesia deepens to the so-called " surgical stage", upon reaching which the surgeon begins the operation. At the end of the operation "force" anesthesia decreases, child wakes up. What happens to the child during the operation? He sleeps without experiencing any sensations, particularly pain. State baby assessed by an anesthesiologist clinically based on the skin, visible mucous membranes, eyes, he listens to the lungs and heartbeat baby, monitoring (surveillance) of the work of all vital important organs and systems, if necessary, laboratory rapid tests are performed. Modern monitoring equipment allows you to monitor heart rate, blood pressure, respiratory rate, the content of oxygen, carbon dioxide, inhalational anesthetics in the inhaled and exhaled air, oxygen saturation in the blood as a percentage, the degree of depth of sleep and the degree of pain relief, the level of muscle relaxation, the ability to conduct a pain impulse By nerve trunk and much, much more. The anesthesiologist provides infusion and, if necessary, transfusion therapy, in addition to drugs for anesthesia Antibacterial, hemostatic, and antiemetic drugs are administered.

Coming 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 recovery from anesthesia up to 15-20 minutes, however, according to established tradition child must be under the supervision of an anesthesiologist for 2 hours after anesthesia. This period may be complicated by dizziness, nausea and vomiting, pain in the area postoperative wound. In children of the first year of life, the usual pattern of sleep and wakefulness may be disrupted, which is restored within 1-2 weeks. The tactics of modern anesthesiology and surgery dictate 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 child After the operation, he is transferred to the intensive care unit, then further monitoring of the condition baby The resuscitator takes over, and here continuity in the transfer of the patient from doctor to doctor is important. How and with what to relieve pain after surgery? In our country, painkillers are prescribed by the attending surgeon. These may be narcotic analgesics ( PROMEDOL), non-narcotic analgesics ( TRAMAL, MORADOL, ANALGIN, BARALGIN), non-steroidal anti-inflammatory drugs ( KETOROL, KETOROLAC, IBUPROFEN) and antipyretic drugs ( PANADOL, NUROFEN).

Possible complications

Modern anesthesiology strives to minimize its pharmacological aggression, reducing the duration of action of drugs, their quantity, removing the drug from the body almost unchanged ( SEVOFLURANE) or completely destroying it with enzymes of the body 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 to the administration of drugs for anesthesia, for transfusion of blood products, when administering antibiotics, etc. The most formidable and unpredictable complication, which can develop instantly, can occur in response to the administration of any drug in any person. Occurs with 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 only be avoided if the patient or his immediate family had previously had a similar reaction to this drug and he is simply excluded from anesthesia. Anaphylactic reactions are difficult and difficult to treat; the basis of therapy is hormonal drugs (for example, ADRENALINE, PREDNISOONE, DEXAMETHASONE). Another serious complication that is almost impossible to prevent and prevent is malignant hyperthermia- a condition in which, in response to the administration of inhalational anesthetics and muscle relaxants, 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 when emergency operations, if little time has passed since the patient’s last meal and the stomach has not completely emptied. In children, aspiration may occur during hardware-mask anesthesia with passive flow of stomach contents into oral cavity. This complication threatens the development of severe bilateral pneumonia, complicated by a burn of the respiratory tract by the acidic contents of the stomach. Respiratory failure - pathological condition, which develops when oxygen delivery to the lungs and gas exchange in the lungs are disrupted, which does not ensure the maintenance of normal gas composition blood. Modern monitoring equipment and careful observation help to avoid or diagnose this complication in a timely manner. Cardiovascular failure- a pathological condition in which the heart is unable to provide adequate blood supply to 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 pain relief. The complex is being carried out resuscitation measures followed by long-term rehabilitation. Mechanical damage - complications that may arise during procedures performed by an anesthesiologist, be it tracheal intubation, venous catheterization, placement of a gastric tube or urinary catheter. A more experienced anesthesiologist will experience fewer of these complications. Modern drugs for anesthesia underwent numerous preclinical and clinical trials - first in adult patients. And only after several years safe use they are allowed in children's practice. Main Feature modern drugs For anesthesia- this is the absence of adverse reactions, rapid elimination from the body, predictability of the duration of action from the administered dose. Based on this, anesthesia is safe, has no long-term consequences and can be repeated repeatedly. Without a doubt, the anesthesiologist has a huge responsibility for the patient's life. Together with the surgeon, he strives to help your child cope with the disease, sometimes being solely responsible for preserving life.