Principles of anaesthesia for term neonates: an updated practical guide

Neonatal Care for Anesthesiologists

“…Many unusual congenital syndromes occur in childhood. These congenital anomalies in newborn period may accompany emergency surgical procedures [24]. Congenital anomalies that may cause difficult intubation should be noted and the anesthesia plan should be made accordingly.…”

“…In laboratory evaluation, a baseline hemoglobin measurement should be obtained for minor surgical procedures [24]. If there is no indication for emergency surgery, anemia should be treated before surgical procedure.…”

“…The anesthesia device must be pre-checked before surgical procedure and anesthesia practice. It is essential that the anesthesia ventilator has the ability to provide neonatal compliance, small tidal volume (usually in pressure controlled ventilator mode) and positive end-expiratory pressure [24]. In recent years, new generation anesthesia machines have been developed which is able to small tidal volumes [28] and to provide the ability to ventilate using pressure support ventilation (PSV) [29].…”

“…Although depending on the choice of anesthetist, induction with inhalation anesthetics is a more preferred method. One of the characteristics of the newborns that are different from older children and adults is that they have relatively high alveolar ventilation but low functional residual capacity [6,14,24]. This higher minute ventilation to FRC ratio with relatively higher blood flow to vessel rich organs contributes to a rapid increase in alveolar anesthetic concentration.…”

“…Intravenous glucose infusion may be required to maintain normoglycemia (serum glucose concentration of 40-90 mg dL [1,24].…”