[Head-injured child: neuro-surgical anesthesia (author's transl)]

Abstract

Our first care when anesthetizing a child having a head injury treated by neurosurgery is to preserve a correct blood perfusion pressure, by using anesthetic agents without vasodilator potency and to control cerebral oedema. The most suitable anesthetic agents are thiopentone, dextromoramide or fentanyl, diazepam and pancuronium. Artificial ventilation is used nearly systematically trying to obtain mild hypocapnia (PaCO2:30-35 Hg pH 7.45) inducing a benefic cerebral vasoconstriction. About the antiedematous agents, mannitol gives best results in case of emergency.