[Preanesthetic evaluation of pediatric patients].
Preoperative evaluation of pediatric patients undergoing anesthesia requires specific consideration. Upper respiratory infection and fever are common problems encountered in the otherwise healthy children who are scheduled for minor surgery. Considerations for the preanesthetic evaluation of the patients with asthma or ex-preterm infants are discussed. It is important to provide less stressful environment to patients and to fulfill patients' satisfaction. Fasting time should be minimum. If patients are extremely anxious and feel fear for separation from their parents, anxiolytic medication might be helpful. Parents present at induction may be another option for smooth induction of anesthesia. Children may have received vaccines. Surgery should be planned in accordance with the vaccination program. Several laboratory examinations can be omitted after careful physical examination and interview. Blood count, ECG, or chest X-ray seldom affect the preoperative preparation or anesthetic method for the patients who do not have any particular findings in physical examination. Such examination is not only unnecessary, but gives stress to those patients. In recent years, there have been some reports that anesthesia during infancy affect the development of the brain and causes learning disability or emotional complication. These findings are mainly based on the results of animal experiments and the effect of anesthetics on the developing brain has not been thoroughly confirmed yet in the clinical settings. We need to keep our eyes on the forthcoming research.
Nishina
Kahoru
K
Kobe University Graduate School of Medicine, Faculty of Medicine, Department of Surgery Related, Division of Anesthesiology and Perioperative Medicine, Kobe 650-0017.
Maekawa
Nobuhiro
N
D000758:Anesthesia; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011300:Preoperative Care