References

Berde CB, Sethna NF. Analgesics for the treatment of pain in children. N Engl J Med. 2002; 347:(14)1094-103

Brodbelt DC, Blissitt KJ, Hammond RA The risk of death: the confidential enquiry into perioperative small animal fatalities. Vet Anaesth Analg. 2008; 35:(5)365-73 https://doi.org/10.1111/j.1467-2995.2008.00397.x

Davis H, Jensen T, Johnson A 2013 AAHA/AAFP fluid therapy guidelines for dogs and cats. J Am Anim Hosp Assoc.. 2013; 49:(3)149-59 https://doi.org/10.5326/JAAHA-MS-5868

Day SL. Artificial ventilation in the small animal operating theatre’. The Veterinary Nursing Journal. 2013; 28:(1)12-16

Dugdale A. Neonates/paediatrics.Oxford: Wiley-Blackwell; 2010

Grubb TL, Perez Jimenez TE, Pettifer GR. Neonatal and Paediatric Patients. In: Grimm KA, Lamont LA, Tranquilli WJ, Greene SA, Roberston SA (eds). Oxford: Wiley Blackwell; 2015

Grubb T, Sager J, Gaynor JS 2020 AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats. J Am Anim Hosp Assoc.. 2020; 56:(2)59-82 https://doi.org/10.5326/JAAHA-MS-7055

Grundy SA. Clinically relevant physiology of the neonate. Vet Clin North Am Small Anim Pract. 2006; 36:(3)443-59

Haskins S. Monitoring Anaesthetized Patients. In: Grimm KA, Lamont LA, Tranquilli WJ, Greene SA, Roberston SA (eds). Oxford: Wiley Black-well; 2015

Jose PA, Logan AG, Slotkoff LM, Lilienfield LS, Calcagno PL, Eisner GM. Intrarenal Blood Flow Distribution in Canine Puppies. Pediatr Res.. 1971; 5:335-44

Kerr CL. Pain Management I: Systemic Analgesics, 3rd Edition. In: Duke-Novakovski T, De Vries M, Seymour C (eds). London: BSAVA; 2016

Lee JA, Cohn LA Fluid Therapy for Pediatric Patients. Vet Clin North Am Small Anim Pract. 2017; 47:(2)373-82 https://doi.org/10.1016/j.cvsm.2016.09.010

The Critical Neonate: Under 4 weeks of Age. 2009. https://www.cliniciansbrief.com/article/critical-neonate-under-4-weeks-age (accessed on 22nd February, 2020)

Lucio CF, Silva LCG, Vannucch CI. Haematological and biochemical analysis of healthy neonatal puppies during the immediate foetal-to-neonatal transition. Reproduction in Domestic Animals. 2019; 54:(10)1419-22

Mathews KA. Analgesia for the pregnant, lactating and neonatal to pediatric cat and dog. Vet Clin North Am Small Anim Pract. 2008; 38:(6)1291-308 https://doi.org/10.1016/j.cvsm.2008.07.001

Mathews K, Kronen PW, Lascelles D Guidelines for Recognition, Assessment and Treatment of Pain: Section 35. Neonatal and Paediatric Patients. J Small Anim Pract. 2014; 55:(6)E10-68 https://doi.org/10.1111/jsap.12200

Intraosseous Catheterization: An Often Underused, Life-Saving Tool. 2009. https://www.cliniciansbrief.com/article/intraosseous-catheterization-often-underused-life-saving-tool (accessed 22nd February, 2020)

Moon PF, Massat BJ, Pascoe PJ. Neonatal critical care. Vet Clin North Am Small Anim Pract. 2001; 31:(2)343-65

Murrell JC. Pre-anaesthetic Medication and Sedation, 3rd Edition. In: Duke-Novakovski T, De Vries M, Seymour C (eds). London: BSAVA; 2016

Nursing notes: paediatric and neonate anaesthesia. 2017. https://www.vettimes.co.uk/article/nursing-notes-paediatric-and-neonateanaesthesia/ (accessed 25th January, 2020)

O'Hagan B., Pasloske K., McKinnon C., Perkins N., Whittem T. ‘Clinical evaluation of alfaxalone as an anaesthetic induction agent in dogs less than 12 weeks of age’. Australian Veterinary Journal. 2012a; 90:(9)346-350

O'Hagan B, Pasloske K, McKinnon C, Perkins N, Whittem T. Clinical evaluation of alfaxalone as an anaesthetic induction agent in cats less than 12 weeks of age. Aust Vet J.. 2012b; 90:(9)346-50 https://doi.org/10.1111/j.1751-0813.2012.00974.x

Pottie RG, Dart CM, Perkins NR, Hodgson DR. Effect of hypothermia on recovery from general anaesthesia in the dog. Aust Vet J.. 2007; 85:(4)158-62

Rigotti CF, Brearley JC. Anaesthesia for Paediatric and Geriatric Patients, 3rd Edition. In: Duke-Novakovski T, De Vries M, Seymour C (eds). London: BSAVA; 2016

Code of Professional Conduct for Veterinary Nurses.London: Royal College of Veterinary Surgeons; 2012

Root Kustritz MV. Pros, Cons, and Techniques of Pediatric Neutering. Vet Clin North Am Small Anim Pract. 2014; 44:(2)221-33 https://doi.org/10.1016/j.cvsm.2013.10.002

Robertson SA, Gogolski SM, Pascoe P, Shafford HL, Sager J, Griffenhagen GM. AAFP Feline Anaesthesia Guidelines. J Feline Med Surg.. 2018; 20:(7)602-34 https://doi.org/10.1177/1098612X18781391

Von Dehn B. Pediatric Clinical Pathology. Vet Clin North Am Small Anim Pract. 2014; 44:(2)205-19 https://doi.org/10.1016/j.cvsm.2013.10.003

Managing pain with opioid analgesics in cats and dogs. 2015. https://www.vettimes.co.uk/article/managing-pain-with-opioid-analge-sics-in-cats-and-dogs/ (accessed3rd January, 2020)

Zaki S, Ticehurst K, Miyaki Y. Clinical evaluation of Alfaxan-CD as an intravenous anaesthetic in young cats. Aust Vet J.. 2009; 87:(3)82-7 https://doi.org/10.1111/j.1751-0813.2009.00390.x

Anaesthesiology

Anaesthetic management of paediatric and neonatal patients

02 May 2020
Clinical
14 mins read
02 May 2020
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.

Abstract

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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anaesthesia
analgesia
paediatric
neonate