الفهرس 
Complications in Pediatric AnesthesiaOnly 14 pages are availabe for public view
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Abstract
The provision of safe anesthesia for the pediatric patient depends at first on a clear understanding of the physiological and anatomical differences between children and adults, especially airway anatomy, cardiovascular and respiratory physiology.
The anesthetic techniques which are done by the anesthetist could be the source of complications. These include techniques for airway management, which are mainly traumatic complications to the airway structures. Also mechanical ventilation and vascular access techniques carry many hazards to the patients.
Difficulty in managing the airway is the most important cause of major anesthesia related morbidity and mortality. The inability to secure the airway, with consequent failure of oxygenation and ventilation, is a lifethreatening complication. Failure of oxygenation leads to hypoxia followed by brain damage, cardiovascular dysfunction, and finally death.
Surgical blood loss and wound infection are common complications that cause significant intraoperative and postoperative morbidity and mortality.
Changing the position of the patient during operation carries many hazards, including changes in the cardiovascular and pulmonary systems. Also trauma to important structures could occur, as peripheral nerve injuries, joint dislocation and eye injuries. So caution should be taken while positioning a pediatric patient.
There are many important differences between adults and children in their response to drugs, including anesthetic and analgesic agents. These differences are most pronounced and clinically important in neonates, premature babies, and infants up to the age of 3-6 months. After this age most differences are not clinically significant.
Changing body temperature during pediatric anesthesia is one of the most important complications. When internal temperature deviates significantly from normal, metabolic functions usually deteriorate, and death may result. Anesthetic-induced inhibition of thermoregulation combines with exposure to a cold operating room environment to make most unwarmed patients hypothermic. In recent years, major outcome studies have shown that mild hypothermia (>1–2°C) triples the incidence of morbid cardiac outcomes, triples the incidence of surgical wound infections and prolongs hospitalization 20 percent, and significantly increases surgical blood loss. An understanding of normal and anesthetic-influenced thermoregulation facilitates prevention and management of these and numerous other temperature-related complications.
Regional anesthetic procedures can infrequently lead to local, regional, or general complications, some of which can be lethal. Local adverse effects usually result from nerve damage due to incorrect needle placement rather than from toxicity of the injected solution. Regional complications are usually due to the interruption of nerve conduction. They occur mainly during epidural and spinal blocks, including hypoventilation, urinary retention following caudal epidural blocks, and complications, such as Horner syndrome, hypoglycemia, and hypotension (in patients older than 8 years old). Systemic toxicity results from inadvertent intravascular injection of local anesthetics, which is often due to neglect of basic safety rules, such as the use of an aspiration test, evaluation of a test dose, and slow speed of injection.