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Review
. 2019 Sep;63(9):771-779.
doi: 10.4103/ija.IJA_591_19.

Anaesthetic concerns in preterm and term neonates

Rajeshwari Subramaniam  1
Affiliations
Review

Anaesthetic concerns in preterm and term neonates

Rajeshwari Subramaniam. Indian J Anaesth. 2019 Sep.

Abstract

Anaesthesia for neonates is a composite of good knowledge of neonatal and transitional physiology combined with skill in airway maintenance and vascular access. When the newborn is a preterm, the complexities of management increase due to the small size and accompanying issues such as bronchopulmonary dysplasia and apnoea. World over, the number of survivors of preterm birth is on the increase. We searched Pubmed for "Anesthesia, apnea, neonatal, neonates, physiology, preterm, spinal anesthesia", as well as cross references from review articles. These babies have a high incidence of conditions warranting surgery (e.g., tracheoesophaeal fistula, congenital diaphragmatic hernia, anorectal malformations, incarcerated hernia, necrotising enterocolitis). The possibility of neurodevelopmental harm by anaesthetics is currently the topic of active research. In parallel, advances in paediatric anaesthesia equipment, use of regional and neuraxial anaesthesia and availability of monitoring have steadily increased the safety of anaesthesia in these tiny patients.

Keywords: Anaesthesia; GAS study; apnoea; neonatal; neonates; neurodevelopmental issues; outcomes; physiology; preterm; spinal anaesthesia.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
A 800-g premature infant positioned for tracheoesophaeal fistula repair
Figure 2
Figure 2
AAP definition of age of neonates and preterms
Figure 3
Figure 3
Preterm infant with large sacrococcygeal teratoma
Figure 4
Figure 4
Intubating a preterm infant using C-Mac videolaryngoscope
Figure 5
Figure 5
Preterm/neonate spine: cord ends L3, dural sac ends at S4; Spine at 1 year: cord ends at L1, dural sac ends at S2
Figure 6
Figure 6
Infant held in sitting position for spinal anaesthesia
See this image and copyright information in PMC

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