Conduct of Anesthesia in Pediatrics:
Preanesthetic Evaluation
Obtain the following history, primarily from the caregiver:
- Antenatal, birth and perinatal history.
- Premature? Resuscitation and NICU admission? Residual deficits?
- Developmental history
- Normal growth and development? Genetic or Metabolic issues?
- Functional history
- Exercise tolerance? Feeding tolerance? Cyanosis? Frequent chest infections? Sleep apnea? Gastroesophageal reflux?
- History of recent common complaints
- Upper respiratory tract infection? Fever? Loose teeth?
- NPO status
- Previous anesthetics
- Airway issues? Adverse events? Postoperative adverse events and pain issues?
Physical examination is limited by cooperation therefore rapid rapport is crucial.
- General observation often sufficient for previously healthy child to avoid increasing anxiety.
- Consider whether parents may assist by being present at induction
- assessment of whether or not premedication is suitable for the child, and by which route (PO, SL, IN, IM)
Next page: Pharmacology of Anesthetic Agents in Pediatric Patients