Recent advances in paediatric anaesthesia

Abstract

Recent development in science has led to a significant improvement in safety for the anaesthetic management of children. Enhanced recovery after surgery is one of the novel approaches aiming to enhance paediatric surgical outcomes and their quick recovery. Preoperative counselling, minimal fasting, and no routine pharmacological premedication are critical components of enhanced recovery after surgery. As anaesthetists, management of airway is our priority and introduction of paraoxygenation in addition to preoxygenation has resulted in reduction in desaturation episodes during periods of apnoea. Safe care has been made possible by improvements in monitoring, equipment, medications, techniques, and resuscitation protocols. We are motivated to collect more evidence regarding ongoing disputes and issues, such as the effect of anaesthesia on neurodevelopment.

Multiple General Anesthesia in Children: A Systematic Review of Its Effect on Neurodevelopment

“…Over the years, significant improvements in terms of monitoring, medications and anesthesiological techniques have been obtained in the field of pediatric anesthesia, thus leading to improvements in recovery after surgical interventions and overall survival following early surgeries [ 23 ]. A crucial point has been the recent conceptualization of pediatric anesthesia, which should be approached differently compared to the one for adults, especially from a pharmacological point of view [ 24 ].…”

Magnesium Sulfate in Pediatric Abdominal Cancer Surgery: Safety and Efficacy in Ultrasound-Guided Transversus Abdominis Plane (US-TAP) Block in Conjugation with Levobupivacaine

“…2 Combining general anesthesia with regional or nerve blocks for this population enables a smooth intraoperative course, reduced need for general anesthetics, avoiding hazardous side effects from parenteral administration of narcotics during surgery, reduced stress response, pain-free awakening, and, most importantly, perfect postoperative pain control. 3 Several regional block methods, including sciatic nerve block, fascia iliaca, ilioinguinal, and iliohypogastric blocks, as well as TAP block and topical analgesia, have been utilized on children, 4 effectively and safely especially with the use the ultrasound to perform the transversus abdominis plane block (US-TAP), as a part of the multimodal anesthetic technique resulting in speedy recovery following lower abdominal surgeries. 5 Because the widespread introduction of ultrasound guidance for peripheral nerve blocks, interest has developed in using the TAP block for perioperative analgesia in various types of surgery involving the abdomen.…”

“… 2 Combining general anesthesia with regional or nerve blocks for this population enables a smooth intraoperative course, reduced need for general anesthetics, avoiding hazardous side effects from parenteral administration of narcotics during surgery, reduced stress response, pain-free awakening, and, most importantly, perfect postoperative pain control. 3 …”

Innovative research and technological advancements: Oars of the boat of progress

“…[ 22 ] The concept of ERAS and its implementation in the fields of onco-anaesthesia, caeserean section and paediatric anaesthesia has been elegantly touched upon in the articles in this issue. [ 13 , 23 , 24 ] ERAS protocols are now being followed even in transplant surgery such as renal and liver transplants. [ 25 ] The advances in transplant anaesthesia are thus proceeding in parallel with the advances in surgical techniques, improved understanding of immunology and rapidly developing laboratory research.…”