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Why is general anesthesia dangerous for a child? Consequences of general anesthesia for a child Effect of anesthesia on a baby

Very often, anesthesia scares people even more than the operation itself. Frightened by the unknown, possible discomfort when falling asleep and waking up, and numerous conversations about the harmful effects of anesthesia. Especially if all this concerns your child. What's happened modern anesthesia? And how safe is it for the child’s body?

In most cases, all we know about anesthesia is 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 child is decided. What do you need to know about anesthesia?

Anesthesia, or general anesthesia, 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.

Types of anesthesia

Depending on the method of administration, anesthesia can be inhalational, intravenous and intramuscular. The choice of anesthesia method 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 quantity and combination of drugs from different groups.

“Small” anesthesia includes inhalation (hardware-mask) anesthesia and intramuscular anesthesia. With machine-mask anesthesia, the child receives an anesthetic drug in the form of an inhalation mixture while breathing independently. Painkillers introduced into the body by inhalation are called inhalational anesthetics (Ftorotan, 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 a short-term switching off of the child’s consciousness is necessary. Currently, inhalation anesthesia is most often combined with local (regional) anesthesia, since it is not effective enough as mononarcosis. Intramuscular anesthesia is now practically not used and is becoming a thing of the past, since the anesthesiologist absolutely cannot control the effect on the patient’s body of this type of anesthesia. In addition, the drug, which is mainly used for intramuscular anesthesia - Ketamine - according to the latest data is not so harmless for the patient: it turns off the long term(almost six months) long-term memory, interfering with full.

“Major” anesthesia is a multicomponent pharmacological effect on the body. Includes the use of such medicinal groups, How 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 administered both intravenously and inhalation through the lungs. During the operation, the patient undergoes artificial pulmonary ventilation (ALV).


Are there any contraindications?

There are no contraindications to anesthesia, except for the refusal of the patient or his relatives to undergo anesthesia. At the same time, 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, anesthesia is necessary, that is, the knowledge and skills of an anesthesiologist are needed. And it is not at all necessary that anesthesia in children 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, the absence of parents, a long forced situation, a dentist with shiny instruments and a drill. Wherever a child needs peace of mind, an anesthesiologist is needed - 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 a child has a concomitant pathology, then it is desirable that the disease is not exacerbated. If a child has been ill with an acute respiratory viral infection (ARVI), 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 a respiratory infection primarily affects respiratory tract.

Before the operation, the anesthesiologist will definitely talk with you about abstract topics: where the child was born, how he was born, whether vaccinations were given and when, how he grew, how he developed, what illnesses he had, whether he has any diseases, examine the child, get acquainted with the medical history, and 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.

Some terminology

Premedication- psycho-emotional and medicinal preparation of the patient for upcoming operation, begins a few days before surgery and ends immediately before surgery. The main goal of remedication is to relieve fear, reduce the risk of developing allergic reactions, prepare the body for upcoming stress, and calm the child. 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 pulmonary ventilation (ALV)- a method of delivering oxygen to the lungs and further to all tissues of the body using an artificial ventilation device. During surgery, they temporarily relax the skeletal muscles, which is necessary for intubation. Intubation- insertion of an incubation 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 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 (erythrocyte mass, fresh frozen plasma, etc.) to compensate for irreplaceable blood loss. Transfusion therapy is an operation for the forced introduction of foreign matter into the body; it is used according to strict health conditions.

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 the modern, safe and most effective long-term action, - Ropivacaine.

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 cases 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, you cannot feed the child; four hours before, you cannot even give him water, and by water we mean a clear, non-carbonated liquid without odor or taste. A newborn who is on can be fed for the last time four hours before anesthesia, and for a child who is on, this period is extended to six hours. A fasting pause will allow you to avoid such complications during the onset of anesthesia as aspiration, i.e. 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 the operation so that during the operation under the influence of anesthesia there is 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 devices in his arsenal to distract the child’s attention from the upcoming anesthesia. This and breathing bags with images of different animals, and face masks with the smell of strawberries and oranges, these are ECG electrodes with images of cute faces of your favorite animals - that is, everything for a child to fall asleep comfortably. But still, parents should stay with the child until he falls asleep. And the baby should wake up next to his parents (if the child is not transferred after the operation to the intensive care unit and intensive care).


During surgery

After the child has fallen asleep, the anesthesia deepens to the so-called “surgical stage”, at which point the surgeon begins the operation. At the end of the operation, the “strength” of anesthesia decreases and the child wakes up.

What happens to the child during the operation? He sleeps without experiencing any sensations, particularly pain. The child’s condition is assessed clinically by the anesthesiologist - by looking at the skin, visible mucous membranes, eyes, he listens to the child’s lungs and heartbeat, monitoring (observation) of the work of all vital functions is used. important organs and systems, if necessary, laboratory rapid tests are performed. Modern monitoring equipment allows you to track your heart rate, blood pressure, respiratory rate, content of oxygen and carbon dioxide in the inhaled and exhaled air, inhalational anesthetics, blood oxygen saturation in 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 through nerve trunk and much, much more. The anesthesiologist carries out infusion and, if necessary, transfusion therapy; in addition to drugs for anesthesia, antibacterial, hemostatic, and antiemetic drugs are administered.

Coming out of anesthesia

The period of recovery from anesthesia lasts no more than 1.5-2 hours, while the drugs administered for anesthesia are in effect (not to be confused with postoperative period, which lasts 7-10 days). Modern drugs can reduce the period of recovery from anesthesia to 15-20 minutes, however, according to established tradition, the child must be under the supervision of an anesthesiologist for 2 hours after anesthesia. This period may be complicated by dizziness, nausea and vomiting, painful sensations 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 a child is transferred to the intensive care unit after surgery, then the resuscitator takes over further monitoring of the child’s condition, 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 can 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 seeks to minimize its pharmacological aggression by 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 can arise during anesthesia and what consequences can they lead to?

Anaphylactic shock - allergic reaction on the administration of drugs for anesthesia, on the 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. 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; they are based on hormonal drugs (for example, Adrenaline, Prednisolone, Dexamethasone).

Another dangerous 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 increases significantly (up to 43 ° C). Most often this is a congenital predisposition. The consolation is that the development of malignant hyperthermia is an extremely rare situation, occurring in 1 in 100,000 general anesthetics.

Aspiration is the 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 can occur during hardware-mask anesthesia with passive flow of stomach contents into the oral cavity. This complication threatens the development of severe bilateral pneumonia and burns of the respiratory tract with the acidic contents of the stomach.

Respiratory failure - pathological condition, which develops when the delivery of oxygen to the lungs and gas exchange in the lungs are disrupted, in which the maintenance of normal blood gas composition is not ensured. Modern monitoring equipment and careful observation help to avoid or timely diagnose this complication.

Cardiovascular failure is a pathological condition in which the heart is unable to provide adequate blood supply to organs. As an independent complication in children, it is extremely rare, most often as a result of other complications, such as anaphylactic shock, massive blood loss, insufficient pain relief. The complex is being carried out resuscitation measures followed by long-term rehabilitation.

Mechanical damage is a complication that may occur during procedures performed by an anesthesiologist, be it tracheal intubation, venous catheterization, insertion of a gastric tube, or urinary catheter. Have more experienced anesthesiologist Fewer of these complications occur.

Modern drugs for anesthesia have undergone numerous preclinical and clinical trials- first in adult patients. And only after several years safe use they are allowed in children's practice. The main feature of modern anesthesia drugs is the absence 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 several times.

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.

06/26/2006 12:26:48, Mikhail

In general, informational good article, it’s a shame that hospitals don’t give such detailed information. My daughter was given about 10 anesthesia in the first 9 months of her life. There was a long anesthesia at the age of 3 days, then a lot of mass and intramuscular ones. Thank God there were no complications. Now she is 3 years old, develops normally, reads poetry, counts to 10. But it’s still scary how all these anesthesia affected her. mental state child. Almost nothing is said about this anywhere. As they say, “saving the main thing, don’t bother with the little things.”
I made a proposal to our doctors to provide a certificate of all manipulations on children, so that parents could calmly read and understand, otherwise everything is on the go, fleeting phrases. Thanks for the article.

I myself underwent anesthesia twice and both times I had the feeling that I was very cold, I woke up and started chattering my teeth, and even a severe allergy began in the form of hives, the spots then increased and merged into a single whole (as I understand it, swelling began). For some reason, the article does not say about such reactions of the body, maybe it’s individual. And it took several months for my head to get better, my memory noticeably decreased. How does this affect children and if a child has neurological problems, what are the consequences of anesthesia for such children?

04/13/2006 15:34:26, Fish

My child has undergone three anesthesia and I really want to know how this will affect his development and psyche. But no one can answer this question for me. I was hoping to find out in this article. But only general phrases that there is nothing harmful in anesthesia. But in general the article is useful for general development and for parents.

A note on conduct. Why is this article placed in the "Car" section? Of course, some connection can be traced, but after an “encounter” with a car, preparing for anesthesia for three days is usually quite problematic;-(

For some reason, the article, and indeed most materials on this topic, do not talk about the effect of anesthesia on the human psyche, and especially on a child. Many people say that anesthesia is not only about “falling and waking up”, but rather unpleasant “glitches” - flying along the corridor, different voices, the feeling of dying, etc. And an anesthetist friend said that these side effects do not occur when using drugs latest generation, for example, recofol.

They are prevented from making an adequate decision by numerous rumors and myths surrounding this topic. Which of them is true and which is speculation? We asked one of the leading experts in this field, the head of the department of anesthesiology and therapy, to comment on the main parental fears associated with pediatric anesthesia critical conditions Moscow Research Institute of Pediatrics and Pediatric Surgery of the Ministry of Health of the Russian Federation, Professor, Doctor of Medical Sciences Andrey Lekmanov.

Myth: “Anesthesia is dangerous. What if my baby doesn’t wake up after the operation?”

In fact: This happens extremely rarely. According to world statistics, this happens in 1 out of 100 thousand planned operations. In this case, most often the fatal outcome is associated not with the reaction to anesthesia, but with the surgical intervention.

In order for everything to go smoothly, any operation (with the exception of emergency cases, when hours or even minutes count) is preceded by careful preparation, during which the doctor assesses the health status of the little patient and his readiness for anesthesia, focusing on a mandatory examination of the child and research including: general analysis blood, blood clotting test, general urine test, ECG, etc. If the child has ARVI, high fever, exacerbation concomitant disease, planned surgery is postponed for at least a month.

Myth: " Modern anesthetics They put you to sleep well, but they give you poor pain relief. The child can feel everything"

In fact: This situation is excluded by the exact choice of dosage of the surgical anesthetic, which is calculated based on the individual parameters of the child, the main of which is weight.

But that's not all. Today, not a single operation is carried out without monitoring the condition of a small patient using special sensors attached to his body, which assess the pulse, respiratory rate, blood pressure and body temperature. Many children's hospitals in our country have the most modern technology, including monitors that measure the depth of anesthesia, the degree of relaxation (muscle relaxation) of the patient and allow with a high degree of accuracy to monitor the slightest deviations in the condition of a small patient during the operation.

Experts never tire of repeating: the main purpose of anesthesia is to make sure that the child is not present at own operation, be it a long-term surgical intervention or a small but traumatic diagnostic examination.

Myth: “Inhalation anesthesia is a thing of the past. The most modern is intravenous"

In fact: 60–70% of surgical interventions for children are performed using inhalation (hardware-mask) anesthesia, in which the child receives an anesthetic drug in the form of an inhalation mixture while breathing independently. This type of anesthesia eliminates or significantly reduces the need to use complex combinations of potent pharmacological agents, characteristic of intravenous anesthesia and is characterized by much greater maneuverability for the anesthesiologist and finer control of the depth of anesthesia.

Myth: “If possible, it is better to do without anesthesia. At least during dental procedures."

In fact: There is no need to be afraid of treating a child’s teeth under general anesthesia. If the treatment involves surgery (tooth extraction, abscesses, etc.), with a large volume of dental procedures (treatment of multiple caries, pulpitis, periodontitis, etc.), with the use of equipment and tools that can frighten the child, without Anesthesia is indispensable. In addition, this allows the dentist to concentrate on the treatment, without being distracted by calming the little patient.

However, only a clinic that has a state license for anesthesiology and resuscitation, which is equipped with all the necessary equipment and has a staff of qualified, experienced pediatric anesthesiologists and resuscitators, has the right to use general anesthesia for dental treatment of children. It won't be difficult to check this.

Myth: “Anesthesia damages brain cells, causing impairment of cognitive functions in a child, reducing his school performance, memory and attention.”

In fact: . And although in most cases this does not affect memory, it is with the conduct general anesthesia violation is often associated cognitive functions in children and adults who have undergone extensive, time-consuming surgery. Cognitive abilities usually recover within a few days after anesthesia. And here a lot depends on the skill of the anesthesiologist, on how adequately he administered the anesthesia, as well as on individual characteristics little patient.

Despite the fact that anesthesia began to be used back in the days of primitive man, modern ordinary people know very little about him. And this ignorance gives rise to many unfounded fears, which intensify many times over when it comes to the need for general anesthesia for children. And such a need arises not only when performing operations on internal organs.

General anesthesia for children is carried out in situations where it is necessary to “turn off” the child’s consciousness so that he does not feel pain, does not feel fear, does not remember what is happening, and, as a consequence of all this, is not exposed to stress, which in itself can have different negative consequences. In addition, anesthesia allows the doctor to carry out medical procedures calmly, without being distracted by the reaction of the little patient. Therefore, such pain relief pursues exclusively good goals.

However, for general anesthesia, drugs are used that in some cases can cause postoperative complications and undesirable consequences. And this is what most often causes anxiety and fear in parents.

Preparing for general anesthesia in a child

Based on the nature and extent of the impact, anesthesiologists distinguish between “major” and “minor” anesthesia. In the first case, stronger and longer-acting drugs are used, and the patient is connected to an artificial respiration apparatus; the second is short-term and is used for short operations, while the patient retains the ability to breathe independently.

In addition, depending on the method of anesthesia, it is divided into:

  • Intramuscular - an anesthetic (usually Ketamine) is injected into the muscle. This method does not allow one to accurately predict the duration of its action and is associated with increased risks postoperative complications, and therefore in modern anesthesiological practice it is used less and less in favor of other types.
  • Intravenous - medications are administered by drip into a vein.
  • Inhalation (hardware-mask) - the patient inhales vapors of drugs through a mask. It is this type of general anesthesia that is most often used during operations on children. It is often combined with local anesthesia.

Regardless of the method of administering the anesthetic, if the operation is planned, careful preparation is carried out in advance. The baby will be carefully examined, the necessary tests will be taken (general blood and urine tests, blood coagulation studies, ECG, etc.), medical history and family history will be studied, and drug therapy will be prescribed aimed at physiological and mental preparation of the patient for the upcoming anesthesia, in particular sedatives and hypnotics are prescribed to reinforce the effect of the upcoming anesthesia.

Against the background of infectious and inflammatory processes (for example, during the development of ARVI and within 1-2 weeks after recovery) and exacerbation chronic diseases surgical interventions are not performed and general anesthesia is not used - all manipulations in this case are delayed until full recovery child or until a period of remission occurs.

On the eve of the operation, a cleansing enema is performed (as an alternative, a diet and laxatives are prescribed) and catheterization of the bladder (that is, emptying it). 6 hours before the start of the manipulation, the child should not be fed; 4 hours before the start of the procedure, the child should not be given any liquid! The first step helps prevent the child from involuntary bowel movement during the operation, the second prevents the possible entry of stomach contents into the respiratory tract and suffocation.

Thus, still on preparatory stage Doctors minimize the risk of complications during and after surgery. But, unfortunately, it is impossible to completely exclude it.

Why general anesthesia is dangerous for children: risks and consequences

It should be noted that the greatest responsibility in similar cases lies with the anesthesiologist. Of course, the surgeon must have all the necessary skills to operate on children. But if the anesthesiologist does not have a sufficient level of professionalism, then nothing else matters. Therefore, you only need to worry about having a good specialist. He selects a combination of drugs used in anesthesia and establishes optimal dosage. The result of such anesthesia is the child's unconscious stay for a certain period necessary for the surgeon's work, and a favorable postoperative outcome.

IN modern practice drugs are used that have stood the test of time and practice on adult patients and only after that were approved for use in children. They act for a strictly defined period of time, have no serious side effects and are quickly eliminated from the body. Thanks to improvements in the drugs used in anesthesia, the child comes out of anesthesia very quickly (within 15-30 minutes) and can immediately move and eat.

And yet, cases of intolerance do occur. Anticipate non-perception of certain medicinal substances, used in anesthesia, is possible only if the patient or his closest blood relatives have previously had similar reactions to medications.

In extreme in rare cases as a result of such intolerance, anaphylactic shock (a very life-threatening condition) or malignant hyperemia develops ( sharp increase body temperature up to 42-43 o C - as a rule, it is based on hereditary predisposition). Also among possible complications- cardiovascular failure (impaired blood supply to tissues and organs), respiratory failure(disruption of gas exchange processes in the lungs), aspiration (reflux of stomach contents into the respiratory tract). When carrying out certain manipulations (placement of catheters on the veins or bladder, tracheal intubation, insertion of a gastric tube), mechanical trauma cannot be excluded.

Additionally, some studies suggest that general anesthesia in children damages brain neurons and leads to cognitive disorders, that is, to disturbances in memory processes: children become more distracted, inattentive, learn and develop worse mentally for some period after surgery, and attention deficit hyperactivity disorder often occurs. But, firstly, the likelihood of such consequences is highest when using intramuscular anesthesia (or rather the already mentioned Ketamine), which is practically not used for children today. Secondly, the validity of such conclusions still remains not fully proven. Thirdly, children under 2 years of age are at greater risk. Fourthly, these phenomena are temporary, and the operation is carried out in connection with real problems with the child’s health. That is, the need for general anesthesia outweighs the likelihood of temporary consequences.

Moreover, it should be understood that serious consequences General anesthesia actually occurs in practice extremely rarely (in 1-2% of cases, or even less often), in exceptional situations. Even if the child falls into this special category of patients, the specially trained medical staff who are involved in the operation will provide him with qualified assistance in a timely manner. In addition, throughout the entire operation, from the first minute until another 2 hours after its completion, the child is under strict medical supervision. To monitor the patient's condition, modern medical equipment, which allows you to keep vital signs under control: pulse, heartbeat and state of heart function, breathing and the level of oxygen/carbon dioxide in exhaled air, blood pressure, depth of sleep, degree of muscle relaxation and pain relief, body temperature, etc., etc. Surgeon always pays attention to the situation skin and mucous membranes of the operated patient. All this allows us to eliminate possible risks even at the stage of the first signs of their likelihood.

The state of anesthesia is completely controlled by doctors, and the patient is under complete control and supervision.

Therefore, parents should not worry too much. It should be understood that general anesthesia is an ally that helps the baby get rid of a real health problem in the best, most painless way. Moreover, if necessary, it can be repeated several times.

General anesthesia for a child up to one year old

Often, doctors prefer to delay surgical procedures that require general anesthesia in children as long as possible, if time is of the essence. In every special case, depending on the state of health and the existing problem, the most favorable period for such treatment.

General anesthesia for infants and children up to one year entails more high risks, since the main systems and organs of the baby (in particular the brain) continue to develop and remain vulnerable to the effects various factors. However, depending on the diagnosis, it is not always possible to wait. And in this case, parents should understand that general anesthesia for the baby will cause much less harm than no necessary treatment.

Otherwise, everything stated above is also relevant for this age category of patients. The greatest difficulty for parents is the “hunger pause” before anesthesia: if the child is on breastfeeding, then he cannot be fed 4 hours before the start of the operation; artificial animals are not given anything for 6 hours. And the doctors will take care of the rest.

General anesthesia for children for dental treatment

General anesthesia is also supported by the fact that there is practically no time to carry it out. absolute contraindications(except for the use of certain medications and parental disagreement). In certain cases, it is recommended to use it even when conducting some diagnostic examinations or, for example, in the process dental treatment. Of course, this is not a type of anesthesia that should be used unreasonably. But in some cases, it allows you to carry out the necessary dental procedures in the best, highest quality manner and at the same time save the child and his family from a lot of suffering.

Experts say that there is no reason to be afraid of general anesthesia during dental treatment in children. But such treatment can only be carried out in specialized clinics having the appropriate licenses, equipment and personnel specially trained for this.

For whatever reason, a child is under general anesthesia, he will not feel any discomfort from the procedure if at the moment of “switching off” his consciousness and returning to reality, someone close to him is nearby. For the rest, just trust the professionals and don’t worry about anything! Everything will be fine!

Especially for - Ekaterina Vlasenko


Anesthesia can be dangerous for children


IN lately V foreign literature more and more reports began to appear about negative consequences of anesthesia in children, in particular, that anesthesia can cause the development of cognitive disorders. Cognitive disorders refer to impairments in memory, attention, thinking, and learning ability. In addition, scientists began to suggest that transferred to early age anesthesia may be one of the reasons for the development of the so-called attention deficit hyperactivity disorder.

The reason for conducting a number of modern studies was the statements of many parents that after undergoing anesthesia their child became somewhat absent-minded, his memory deteriorated, his school performance decreased, and in some cases even lost some previously acquired skills.

Back in 2009, an article was published in the American journal Anesthesiology about the significance of the first anesthesia, in particular, the age of the child at which it was performed, in the occurrence of behavioral disorders and intellectual development disorders. The results of the study showed that cognitive disorders were more likely to develop in children who underwent anesthesia before the age of 2 years, rather than at a later time. However, it should be noted that this study was retrospective in nature, that is, it was done “after the fact,” so the scientists concluded that new studies were needed to confirm the results obtained.

Time passed, and just recently, in a relatively recent issue of the American journal Neurotoxicology and Teratology (August 2011), an article appeared with a heated discussion among scientists about the potential harm of anesthesia on the brain of a growing child. Thus, the results of recent studies on primate cubs showed that within 8 hours after anesthesia with isoflurane (1%) and nitrous oxide (70%) a significant number of deaths occurred in the primate brain. nerve cells(neurons). Although this was not found in a rodent study, given the great genetic similarity of primates to humans, it was concluded that anesthesia may be potentially harmful to the human brain during its active development. Scientists have concluded that avoiding anesthesia during a vulnerable stage of brain development in children will prevent neuronal damage. However, a clear answer to the question of what time frame includes the sensitive period of child brain development has not been obtained.

In the same year (2011) in Vancouver, at the annual meeting of the International Society for Anesthesia Research, a number of reports were made regarding the safety of anesthesia in children. Dr. Randall Flick (Associate Professor of Anesthesiology and Pediatrics, Mayo Clinic) presented findings from a recent Mayo Clinic study on the potential negative effects of anesthesia in young children. The study showed that under the age of 4 years, prolonged exposure to anesthesia (120 minutes or more) increases the likelihood of post-anesthesia cognitive impairment by 2 times. In this regard, the authors of the study consider it justified to postpone the planned surgical treatment up to the age of four, under the unconditional condition that delaying the operation will not harm the child’s health.

All this new data, combined with early research on animals became the reason to start additional research, which should help determine the mechanism of action of individual anesthetics on the child’s brain, establish new guidelines for choosing safe anesthesia, and therefore minimize all possible negative consequences of anesthesia in children.

Carrying out most surgical operations these days is unthinkable without adequate anesthesia. Despite the fact that general anesthesia has long been successfully used in pediatrics, parents are frightened by the prospect of it. little baby- scare possible dangers and complications after surgery, the question of the consequences for the child is of concern. 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 is special condition organism, in which, under the influence of special drugs, the patient falls into sleep, complete loss of consciousness and loss of sensitivity occurs. Children do not tolerate any medical procedures well, so when major 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. The doctor also needs anesthesia - diverting attention to the child’s reaction can lead to mistakes 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 we grow older. For children under three years of age, it is advisable to administer the first medications in a familiar environment and in the presence of their parents. It is preferable to carry out induction of anesthesia at this age using a special toy mask, diverting attention from unpleasant sensations.

Carrying out mask anesthesia for a child

As the child grows older, he or she tolerates manipulations more calmly - a child of 5-6 years old can be involved in introductory anesthesia - for example, invite 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 correct dosage of the drug, since children'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. As a rule, a general blood and urine test, a study of the coagulation system, an ECG, and a pediatrician’s conclusion about general condition health. On the eve of the operation, a consultation with an anesthesiologist who will administer general anesthesia is required. The specialist will examine the child, clarify the absence of contraindications, and find out the exact body weight for calculation. required dosage and will answer all questions parents may have. It is important to make sure there is no runny nose - nasal congestion is a contraindication to anesthesia. Other important contraindication to anesthesia - an increase in temperature for unknown reasons.

Before general anesthesia, the child must be examined by doctors.

The baby's stomach must be completely empty during anesthesia. 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 up to one year old, the last time they receive the breast is 4 hours before surgery. Children under 1 year of age who are in artificial feeding, maintain a fasting pause of 6 hours. Children over 5 years old have their last meal the night before, and 4 hours before anesthesia it is contraindicated to drink plain water.

How is anesthesia administered in childhood?

The anesthesiologist always tries to minimize the unpleasant sensations from anesthesia for the child. For this purpose, premedication is carried out before the operation - the baby is offered sedatives, relieving anxiety and fear. Children under the age of three or four years already in the ward receive drugs that put them into a state of half-sleep and complete relaxation. Small children under 5 years old experience separation from their parents very painfully, so it is advisable to stay with the child until he falls asleep.

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

Introduction to anesthesia occurs differently depending on the age of the child.

After falling asleep, the doctor adjusts the depth of anesthesia and carefully monitors vital signs - measures blood pressure, monitors the condition of the child’s skin, and evaluates heart function. In cases where general anesthesia is administered infant up to a year, 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 for 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.

Conducting general anesthesia for a 1 year old child

But if there is an urgent need, anesthesia is also given at this age - anesthesia will cause less harm than the absence of the necessary treatment. The greatest difficulties in children under one year of age are associated with observing a fasting break. 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 taking into account contraindications. It is believed that anesthesia can cause damage neural connections in the brain, promotes increased intracranial. At risk for developing unpleasant consequences Children under 2-3 years of age and younger children, especially those with diseases of the nervous system, are considered. However, it should be noted that similar symptoms in most cases, developed with the introduction of outdated anesthetics, and modern anesthetics have minimal side effects. In most cases, the unpleasant symptoms disappeared some time after the operation.

Children under 2-3 years of age endure anesthesia the hardest

From probable complications development is considered the most dangerous anaphylactic shock, which occurs when you are allergic to the injected drug. Aspiration of gastric contents is a complication that is more common during emergency operations when there is 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, select the correct drug and its dosage, and also quickly take action in case of complications.