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Anaesthetic management of paediatric and neonatal patients

02 May 2020
14 mins read
Volume 11 · Issue 4
Figure 1. Preparation area set up prior to neonatal anaesthesia with a paediatric modified t-piece, warming devices, multiparameter monitor and syringe driver.


This article aims to highlight the key physiological differences in the paediatric patient in comparison to the adult and how they may impact anaesthetic management in practice from pre-operative considerations through to recovery. The critical importance of communication within the veterinary team is highlighted to ensure successful outcomes and reduce the risk of mortality. Potential complications are discussed as they are inherent to anaesthesia, however early identification and intervention can help ensure patient safety. Although paediatric and neonatal anaesthesia may be challenging, it can also be incredibly satisfying for the registered veterinary nurse (RVN) as specific nursing care needs to be provided throughout the peri-operative period to facilitate a smooth anaesthetic and recovery.

In terms of anaesthesia, ’neonate’ can be defined as canine or feline patients aged from birth to weaning or <4 weeks of age, and ‘paediatric’ can be defined as those aged 4 weeks to 6 months of age. Paediatric patients present a unique set of challenges and therefore careful anaesthetic planning is required. A variety of factors should be considered because of the anatomical and physiological differences presented in these patients as they are still developing, have a high metabolic rate and limited body energy reserves. Therefore, it is vital that the registered veterinary nurse (RVN) monitoring and maintaining the anaesthetic has a solid understanding of these considerations in addition to the physiological effects of anaesthetic drugs used, and that appropriate monitoring techniques are utilised in order to ensure successful outcomes.

Although young patients are capable of rapid repair, it was stated by Rigotti and Brearley (2016) that these patients have a reduced capacity to compensate in response to physiological changes that are caused by the administration of anaesthetic drugs as their organs are still undergoing development, and are particularly vulnerable to lasting damage that may not be identified until later in life.

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