For developing ambitions, we need exposure to the world

Then only we can check, who resides in us!

What medication will save the life?

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Pain is a really strong opponent; tackling him is very difficult and needs extraordinary planning

Nerve blocksEpidural analgesiaIv opioidsMultimodal analgesia

Who is willing and prepared for a try….. To bell the cat?

Introduction to Paediatric Introduction to Paediatric ANAESTHESIAANAESTHESIA

Dr Unnikrishnan P M.D.,D.A.,P.D.C.C.[Neuroanaesthesia]

Asst. ProfessorDept of Anaesthesiology

Travancore Medical College,,Kerala, India

Understanding a kid is very very difficult

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They come with a very Soft heart!.

Tender kidneys

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A thief should always ensure the exit before intruding into a house

Immature liver

If removal is difficult, install carefully!

Damage prone respiratory mechanics

Weak members make the whole system weak!

Oh..! I hate cold O.T.s

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My body is full of water!

Inhaled anaesthetics

Not so sweet; be carefulHalothaneIsofluraneSevofluraneDesflurane

We tell the mother not to give milk before anaesthesia, but what we are going to give…? Milk again!

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Intravenous anaesthetic agents

ThiopentonePropofolKetamineEtomidate

Others

DiazepamMidazolamDexmedetomidine

Opioids

morphineMeperidine or pethidineFentanylAlfentanilSufentanilRemifentanil

Dont relax after giving relaxants!

Succinyl cholinePancuroniumVecuroniumAtracuriumRocuronium

Reversal agents

NeostigmineEdrophonium

Are we comfortable about needles?Then what about the child?

FastingPremedicationChild with URIChild with full stomachDifficult airway

Taking off….

Airway access and maintenance

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Airway access and maintenance

y

LARYNGEAL MASK AIRWAY [L.M.A.]

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Size of LMA WEIGHT OF CHILD

11.522.53456

≤5 kg5-10 kg10-20 kg20-30 kg30-50 kg50-70 kg70-100 kg>100 kg

Fluid maintenance

Holliday and Segar formula

Fluid maintenance

lactated Ringer's solution should be used for all deficits and third-space losses. If a child is thought to be at risk for hypoglycemia, 5% dextrose in 0.45% normal saline should be administered by “piggyback” infusion at maintenance rates. For most children, lactated Ringer's solution is the only fluid required.

Blood replacement

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Blood replacement

blood volume is approximately 100 to 120 mL/kg for a preterm infant, 90 mL/kg for a full-term infant,80 mL/kg for a child 3 to 12 months old, and 70 mL/kg for a child older than 1 year.

REVERSAL AND EXTUBATION

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REVERSAL AND EXTUBATION

• Lorem

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THANK YOU!