Biomaterial Database

Anesthesia for the micropremie. 1998

J P Spaeth, and I B O'Hara, and C D Kurth

Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, and the University of Pennsylvania School of Medicine, 19104, USA.

Providing anesthesia for the micropremie involves many considerations beyond what is needed for the full-term neonate. Immaturity of the airway, lungs, cardiovascular system, liver, kidneys, and central nervous system makes the micropremie susceptible to anesthestic complications. Immature respiratory mechanisms and respiratory control increase the risk of apnea, hypoxemia, and hypercapnia intraoperatively as well as postoperatively. Anesthetic drugs depress myocardial contractility and impair baroreflexes in the micropremie to increase the risk of hypotension during anesthesia. Drug metabolism in the micropremie is slow because of the immature liver and kidneys. The micropremie brain requires less drug to achieve the anesthetized state. As a result, administration of the dose and timing of anesthetic drugs differs in the micropremie compared with the full-term neonate. This article describes anesthetic considerations for a few surgical prodedures common in the micropremie.

UI	MeSH Term	Description	Entries
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007234	Infant, Premature	A human infant born before 37 weeks of GESTATION.	Neonatal Prematurity,Premature Infants,Preterm Infants,Infant, Preterm,Infants, Premature,Infants, Preterm,Premature Infant,Prematurity, Neonatal,Preterm Infant
D012119	Respiration	The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (	Breathing
D002319	Cardiovascular System	The HEART and the BLOOD VESSELS by which BLOOD is pumped and circulated through the body.	Circulatory System,Cardiovascular Systems,Circulatory Systems
D004374	Ductus Arteriosus, Patent	A congenital heart defect characterized by the persistent opening of fetal DUCTUS ARTERIOSUS that connects the PULMONARY ARTERY to the descending aorta (AORTA, DESCENDING) allowing unoxygenated blood to bypass the lung and flow to the PLACENTA. Normally, the ductus is closed shortly after birth.	Patent Ductus Arteriosus Familial,Patency of the Ductus Arteriosus,Patent Ductus Arteriosus
D006552	Hernia, Inguinal	An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.	Inguinal Hernia,Inguinal Hernia, Direct,Inguinal Hernia, Indirect,Direct Inguinal Hernia,Direct Inguinal Hernias,Hernia, Direct Inguinal,Hernia, Indirect Inguinal,Hernias, Direct Inguinal,Hernias, Indirect Inguinal,Hernias, Inguinal,Indirect Inguinal Hernia,Indirect Inguinal Hernias,Inguinal Hernias,Inguinal Hernias, Direct,Inguinal Hernias, Indirect
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000758	Anesthesia	A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
D000777	Anesthetics	Agents capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general ANESTHESIA, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site.	Anesthetic,Anesthetic Agents,Anesthetic Drugs,Anesthetic Effect,Anesthetic Effects,Agents, Anesthetic,Drugs, Anesthetic,Effect, Anesthetic,Effects, Anesthetic
D019102	Infant, Very Low Birth Weight	An infant whose weight at birth is less than 1500 grams (3.3 lbs), regardless of gestational age.	Very Low Birth Weight,Very-Low-Birth-Weight Infant,Infant, Very-Low-Birth-Weight,Infants, Very-Low-Birth-Weight,Very Low Birth Weight Infant,Very-Low-Birth-Weight Infants