Pharmacology of Anesthetic Agents in Pediatric Patients:
In general, the same anesthetic drugs used in adult are used in pediatric practice.
Emergence Delirium
- A phenomenon of dysphoria or agitation following anesthesia (not due to pain or anxiety).
- More likely after Sevoflurane-based maintenance of anesthesia.
- May reduce risk through use of propofol, ketamine, midazolam or dexmedetomidine.
Nitrous Oxide
- Commonly used to initiate mask induction, followed by sevoflurane.
- May be mixed with sevofluorane for faster inhalational induction via second gas effect.
Neurocognitive Impact of Anesthesia
- Studies are still inconclusive for long term effects in humans.
- Though likely no lasting effects, small studies have suggested short term deficits in memory and impairment on neurocognitive testing.
Next page: Laryngoscopy and Airway Devices in Pediatric Anesthesia