Why is general anesthesia dangerous for a child? Yes, in some cases it is necessary. Often - to save the life of a child.

But also negative sides the effects of anesthesia exist. That is, it is like a coin that has two sides, like a double-edged sword.

Naturally, before a child’s upcoming operation, parents try to find out how dangerous this intervention is and what exactly is the danger of general anesthesia for the child.

Sometimes general anesthesia scares people even more than surgery. In many ways, this anxiety is fueled by numerous conversations around.

Surgeons who prepare a patient for surgery talk little about anesthesia. And the main specialist in this matter - the anesthesiologist - advises and explains everything only shortly before the operation.

So people are looking for information on the Internet. And here she is, to put it mildly, different. Who to believe?

Today we’ll talk about the types of anesthesia in the nursery. medical practice, about indications and contraindications for it, about possible consequences. And, of course, we will dispel myths in this topic.

Many medical manipulations They are very painful, so even an adult cannot endure them without pain relief. What can we say about the child?..

Yes, subjecting a child to even a simple procedure without pain relief is a huge stress for small organism. This may cause neurotic disorders(tics, stuttering, sleep disturbances). And also this is a lifelong fear of people in white coats.

That's why to avoid discomfort and reduce stress from medical procedures, use pain-relieving techniques in surgery.

General anesthesia is actually called anesthesia. This is an artificially created, controlled state in which there is no consciousness and no reaction to pain. At the same time, vital important functions body (breathing, heart function).

Modern anesthesiology has advanced significantly over the past 20 years. Thanks to it, today it is possible to use new drugs and their combinations to suppress involuntary reflex reactions of the body and reduce muscle tone when such a need arises.

According to the method of administration, general anesthesia in children can be inhalation, intravenous and intramuscular.

In pediatric practice, inhalation (hardware-mask) anesthesia is more often used. With machine-mask anesthesia, the child receives a dose of painkillers in the form of an inhalation mixture.

This type of anesthesia is used for short, simple operations, as well as for some types of research when a short-term switching off of the child’s consciousness is required.

Painkillers used during machine anesthesia are called inhalational anesthetics (Ftorotan, Isoflurane, Sevoflurane).

Intramuscular anesthesia is practically not used for children today, since with such anesthesia it is difficult for the anesthesiologist to control the duration and depth of sleep.

It has also been established that such a frequently used drug for intramuscular anesthesia as Ketamine is unsafe for the child’s body. Therefore, intramuscular anesthesia is leaving pediatric practice.

For long and difficult operations, intravenous anesthesia is used or combined with inhalation. This allows you to achieve a multicomponent pharmacological effect on the body.

Intravenous anesthesia involves the use of various medications. Here are used narcotic analgesics(not drugs!), muscle relaxants that relax skeletal muscles, sleeping pills, various infusion solutions.

During the operation, the patient is given artificial ventilation lungs (ventilator) with a special device.

Accepts final decision Only an anesthesiologist can tell you about the need for a particular type of anesthesia for a particular child.

It all depends on the condition of the little patient, on the type and duration of the operation, on the availability concomitant pathology, from the qualifications of the doctor himself.

To do this, before the operation, parents must tell the anesthesiologist as much information as possible about the characteristics of the child’s growth and development.

In particular, the doctor should learn from parents and/or medical records:

• how pregnancy and childbirth proceeded;
• what type of feeding was it: natural (up to what age) or artificial;
• what illnesses the child suffered;
• whether there were cases of allergies in the child himself or in close relatives and to what exactly;
• what is the child’s vaccination status and whether any negative reactions of the body during vaccination have been previously identified.

Contraindications

There are no absolute contraindications to general anesthesia.

Relative contraindications may include:

The presence of concomitant pathology that can negatively affect the condition during anesthesia or recovery after it. For example, constitutional anomalies accompanied by hypertrophy of the thymus gland.

A disease accompanied by difficulty in nasal breathing. For example, due to a deviated nasal septum, proliferation of adenoids, chronic rhinitis (for inhalation anesthesia).

Having an allergy to medications. Sometimes the child is given allergy tests before surgery. As a result of such tests (skin tests or in vitro tests), the doctor will have an idea of ​​which drugs the body takes and which it gives an allergic reaction to.

Based on this, the doctor will decide in favor of using one or another drug for anesthesia.

If the child suffered ARVI or another infection with fever the day before, the operation is postponed until full recovery body (the interval between the disease and treatment under anesthesia must be at least 2 weeks).

If the child has eaten before surgery. Children with a full stomach are not allowed to undergo surgery, as there is high risk aspiration (stomach contents entering the lungs).

If the operation cannot be postponed, the gastric contents can be evacuated using a gastric tube.

Before the operation or hospitalization itself, parents should provide psychological preparation to the child.

Hospitalization itself for a baby, even without surgery, is a difficult ordeal. The child is frightened by separation from his parents, a foreign environment, a change of regime, people in white coats.

Of course, not in all cases the child needs to be told about the upcoming anesthesia.

If the disease interferes with the child and brings him suffering, then the child needs to be explained that the operation will relieve him of the disease. You can explain to the child that with the help of a special children's anesthesia, he will fall asleep and wake up when everything is done.

Parents should always talk about how they will be with their child before and after surgery. Therefore, the baby must wake up after anesthesia and see the people closest to him.

If the child is old enough, you can explain to him what awaits him in the near future (blood test, blood pressure measurement, electrocardiogram, cleansing enema, etc.). This way the child won't be scared various procedures because he didn't know about them.

The hardest thing for parents and young children is to maintain a hunger pause. I have already spoken about the risk of aspiration above.

The child should not be fed 6 hours before anesthesia, and 4 hours before the anesthesia the child should not even be given water.

A breastfed baby can be put to the breast 4 hours before the upcoming operation.

A child receiving formula milk should not be fed 6 hours before anesthesia.

Before the operation, the small patient’s intestines are cleaned with an enema to prevent involuntary stool passing during the operation. This is very important when abdominal operations(on the abdominal organs).

In children's clinics, doctors have many devices in their arsenal to distract children's attention from upcoming procedures. These include breathing bags (masks) with images of various animals, and scented face masks, for example, with the scent of strawberries.

There are also special children's ECG devices in which the electrodes are decorated with images of the faces of different animals.

All this helps to distract and interest the child, conduct an examination in the form of a game, and even give the child the right to choose, for example, a mask for himself.

Consequences of anesthesia for a child’s body

In fact, a lot depends on the professionalism of the anesthesiologist. After all, it is he who selects the method of administering anesthesia, necessary drug and its dosage.

In pediatric practice, preference is given to proven drugs with good tolerability, that is, with minimal side effects, and which are quickly eliminated from the child’s body.

There is always a risk of intolerance to drugs or their components, especially in children prone to allergies.

It is possible to predict this situation only if the child’s close relatives had a similar reaction. Therefore, this information is always clarified before the operation.

Below are the consequences of anesthesia, which can arise not only due to intolerance to medications.

• Anaphylactic shock (immediate allergic reaction).
• Malignant hyperemia (temperature rise above 40 degrees).
• Cardiovascular or respiratory failure.
• Aspiration (return of stomach contents into Airways).
• Mechanical trauma cannot be excluded during venous catheterization or Bladder, tracheal intubation, insertion of a probe into the stomach.

The likelihood of such consequences exists, although it is extremely small (1-2%).

IN Lately Information has emerged that anesthesia can damage the neurons of a child’s brain and affect the baby’s rate of development.

In particular, it is assumed that anesthesia disrupts memory processes new information. It is difficult for the child to concentrate and learn new material.

This pattern was assumed after using injectable drugs such as Ketamine for intramuscular anesthesia, which is practically not used in pediatric practice today. But the validity of such conclusions still remains unproven.

Moreover, if such changes exist, they are not lifelong. Cognitive abilities usually recover within a few days after anesthesia.

Children recover from anesthesia much faster than adults, since metabolic processes are faster and adaptation capabilities young body higher than in adulthood.

And here a lot depends not only on the professionalism of the anesthesiologist, but also on individual characteristics child's body.

Children are at greater risk early age, that is, up to two years. In children at this age, the nervous system is actively maturing, and new neural connections are being formed in the brain.

Therefore, operations under anesthesia are, if possible, postponed until after 2 years.

Myths about anesthesia

“What if the child doesn’t wake up after the operation?”

World statistics say that this is extremely rare (1 in 100,000 operations). Moreover, more often than not, such an outcome of the operation is associated not with the reaction to anesthesia, but with the risks of the surgical intervention.

It is in order to minimize such risks that the patient undergoes a thorough examination during planned operations. If any abnormalities or diseases are detected, the operation is postponed until full recovery little patient.

“What if the child feels everything?”

Firstly, no one calculates the dosage of anesthetics for anesthesia “by eye”. Everything is calculated based on the individual parameters of the small patient (weight, height).

Secondly, during the operation the child’s condition is constantly monitored.

Monitor pulse, breathing rate, arterial pressure and the patient's body temperature, oxygen/carbon dioxide level in the blood (saturation).

IN modern clinics With good operating equipment, you can even monitor the depth of anesthesia and the degree of relaxation of the patient’s skeletal muscles. This allows you to accurately monitor minimal deviations in the child’s condition during surgery.

“Mask anesthesia is an outdated technique. More safe look intravenous anesthesia"

Most operations (more than 50%) in pediatric practice are performed using inhalation (hardware-mask) anesthesia.

This type of anesthesia eliminates the need for strong medicines and their complex combinations, in contrast to intravenous anesthesia.

At the same time, inhalation anesthesia gives the anesthesiologist greater opportunity for maneuver and allows better management and control of the depth of anesthesia.

In any case, regardless of the reasons for which a child is indicated for surgery with anesthesia, anesthesia is a necessity.

This is a savior, an assistant who will help you get rid of the disease in a painless way.

After all, even with minimal intervention under local anesthesia When a child sees everything but does not feel, not every child’s psyche can withstand this “spectacle.”

Anesthesia allows treatment of non-contact and low-contact children. Provides comfortable conditions for the patient and the doctor, reduces treatment time and improves its quality.

Moreover, not in all cases we have the opportunity to wait, even if the child is small.

In this case, doctors try to explain to parents that leaving the child’s illness without surgical treatment, can provoke greater consequences than the likelihood of developing temporary consequences of general anesthesia.

Practicing pediatrician and twice-mother Elena Borisova-Tsarenok told you how dangerous general anesthesia is for a child.

General anesthesia, used in children, can have many consequences. Children's body It grows and develops very quickly, and any interference with the functioning of the central nervous system can negatively affect the development of the child. This article discusses the main complications that may develop after surgical interventions using general anesthesia.

General anesthesia

General anesthesia is a condition deep sleep which is called medications. Thanks to anesthesia, doctors have the opportunity to perform long and complex operations. This is especially significant in pediatric surgery, because now children who are born with severe developmental defects have a chance to live of cardio-vascular system and with other deviations.

But anesthesia itself is not a harmless procedure. Recently, doctors have conducted a lot of research on its complications and consequences. A special place in their work was given to the influence of general anesthesia on children. Speaking about adults, more relevant are allergic reactions In addition to the drugs administered and cardiac complications, in the case of children, problems associated with slow development and disruption of the central nervous system come to the fore.

Drugs used for general anesthesia in children under three years of age can affect the development and formation of nerve connections between neurons in the brain and the processes of myelination of nerves (formation of a sheath around a nerve fiber). These changes in the central nervous system and are the reasons negative consequences in child development. When deciding on an operation, the doctor must always weigh the need for it with the harm to the child’s body.

Early complications of general anesthesia

This group of complications is not much different from the same in adults. They usually develop while the child is under anesthesia, or in a short period after it. These complications are caused by the direct effect of the drug on the child’s body. These include:

• Allergic reactions: anaphylactic shock, Quincke's edema.
• Stupor, coma.
• Heart rhythm disturbances, in the form of atrioventricular arrhythmia, His bundle block.

With these sharp and dangerous complications Anesthesiologists must cope. Fortunately, they occur quite rarely.

The anesthesiologist constantly monitors the patient's condition during anesthesia

Late complications after anesthesia in children

Even if the operation was successful, without complications, and there was no reaction to the anesthetic, this does not guarantee that there was no negative effect on the child’s body. Long-term consequences do not appear immediately. They can become noticeable even after a few years.

TO late complications relate:

1. Cognitive disorders and attention deficit hyperactivity disorder are described in detail below.
2. Chronic and frequent headaches, sometimes in the form of migraines. The occurrence of a headache is usually not associated with any triggering factors. The whole head may hurt, or half of it. The pain is practically not relieved by analgesics.
3. Sluggish disorders in the liver and kidneys.
4. Frequent dizziness.
5. Leg muscle cramps.

Cognitive disorders develop most often. These include:

• Memory disorders in children. It may be difficult to remember educational material. For example, children may find it difficult to teach foreign languages, poetry. Memory can also be impaired for other reasons, for example, due to a lack of iodine in the body.

It is difficult for a child to remember new material

• Violation logical thinking. It is difficult for children to draw conclusions and look for connections between events.
• Difficulty concentrating on one thing. Such children do not like to read books, they find it difficult at school. Usually during training they are distracted and talk. And parents punish and scold them, instead of understanding the reason for the child’s behavior.

In addition to cognitive disorders, anesthesia is dangerous due to the possibility of developing attention deficit hyperactivity disorder. It is manifested by impulsive behavior, impaired attention of the baby and hyperactivity. Such children cannot predict the consequences of their actions, which is why they are frequent guests of trauma centers. They find it difficult to complete any task or adhere to the rules of the game. Hyperactivity is manifested by difficulty sitting in one place for a long time. During lessons they fidget, turn from side to side, chat with classmates.

Hyperactive child

Consequences in young children

The central system in children under three years of age develops very quickly. And at three years the brain weight is almost the same as that of an adult. Any interventions at this age may entail severe consequences. General anesthesia at this age is especially harmful and dangerous.

In addition to attention deficit disorder and cognitive disorders, it can cause harm in the formation of nerve pathways and fibers, connections between parts of the brain, which can lead to the following consequences:

1. Lag in physical development. The drugs can harm the parathyroid gland, which is responsible for the growth of the child. Such children may be delayed in growth, but as a rule, they later catch up with their peers.
2. Slowdown psychomotor development. Children who have undergone general anesthesia may find it difficult to learn to read, remember numbers, pronounce words correctly, and construct sentences.
3. Epilepsy. This complication is quite rare, but has been described clinical cases when this disease started after surgical interventions.

Is it possible to prevent the development of complications?

It is difficult to say whether there will be a complication, when and how it will appear. But you can try to reduce the risk of developing negative consequences in the following ways:

1. Carefully examine the baby’s body, if possible. During planned operations, it is better to do all the examinations suggested by the attending doctor.
2. After surgery, use medications that will improve cerebral circulation, vitamins. A neurologist will help you select them. This could be Piracetam, Cavinton, B vitamins and others.
3. Closely monitor the condition and development of your child. It is better to consult a doctor once again to exclude harm from anesthetics.

Having learned about the existence of all these terrible complications, you should not refuse upcoming operations. The main thing is to be attentive to the baby’s health, not to self-medicate at home, and if there is the slightest deviation in his health, go to the pediatrician.

Unfortunately, children quite often end up on the operating table – both for injuries and various diseases. The modern level of medicine allows even newborn children to operate under anesthesia, and they tolerate it well.

Many parents are afraid not so much of the operation itself on their child as of anesthesia, fearing what complications it may cause and how it will affect the child’s health. further development. In this regard, there is no need to dramatize the situation. Anesthesia for children is given with special drugs, according to special schemes, taking into account the age and weight of the child; in most cases, inhalation is used.

As for recovery from anesthesia, as a rule, in children it occurs faster and more painlessly than in adults, thanks to good blood circulation and a more mobile nervous system. On average, this period lasts no more than 1.5 hours, but modern means allow you to stop the effect of anesthesia within 15-20 minutes after surgery.

After waking up, the child most often vomits; it is usually a little, but care must be taken to ensure that the vomit does not enter the respiratory tract. Young children may cry after waking up due to pain in the wound; their sleep and wakefulness patterns often change, they experience increased excitability and the need for movement, unlike adults.

Therefore, in the early postoperative period the child is prescribed painkillers and sedatives. It is also possible for the child to be active early and drink plenty of fluids, depending on the complexity of the operation performed. But in general, the recovery of children from anesthesia is faster and smoother than that of adults.

Attention! The information on the site is presented by specialists, but is for informational purposes only and cannot be used for self-treatment. Be sure to consult your doctor!

They are prevented from making an adequate decision by numerous rumors and myths surrounding this topic. Which of them is true and which is speculation? We asked one of the leading experts in this field, the head of the department of anesthesiology and therapy, to comment on the main parental fears associated with pediatric anesthesia critical conditions Moscow Research Institute of Pediatrics and Pediatric Surgery of the Ministry of Health of the Russian Federation, Professor, Doctor of Medical Sciences Andrey Lekmanov.

Myth: “Anesthesia is dangerous. What if my baby doesn’t wake up after the operation?”

In fact: This happens extremely rarely. According to world statistics, this happens in 1 out of 100 thousand planned operations. In this case, most often the fatal outcome is associated not with the reaction to anesthesia, but with the surgical intervention itself.

In order for everything to go smoothly, any operation (except emergency cases, when hours and even minutes count) is preceded by thorough preparation, during which the doctor assesses the health status of the small patient and his readiness for anesthesia, focusing on a mandatory examination of the child and studies, including: general analysis blood, blood clotting test, general urine test, ECG, etc. If the child has ARVI, heat, exacerbation concomitant disease, elective surgery postponed for at least a month.

Myth: “Modern anesthetics are good for sleep, but bad for pain. A child can feel everything"

In fact: This situation is excluded by the exact choice of dosage of the surgical anesthetic, which is calculated based on the individual parameters of the child, the main of which is weight.

But that's not all. Today, not a single operation is carried out without monitoring the condition of a small patient using special sensors attached to his body, which assess the pulse, respiratory rate, blood pressure and body temperature. Many children's hospitals in our country have the most modern technology, including monitors that measure the depth of anesthesia, the degree of relaxation ( muscle relaxation) of the patient and allowing with a high degree of accuracy to monitor the slightest deviations in the condition of a small patient during the operation.

Experts never tire of repeating: the main purpose of anesthesia is to prevent the child from being present at his own operation, be it a long-term surgical intervention or a small but traumatic diagnostic examination.

Myth: " Inhalation anesthesia- yesterday. The most modern is intravenous"

In fact: 60–70% of surgical interventions for children are performed using inhalation (hardware-mask) anesthesia, in which the child receives an anesthetic drug in the form of an inhalation mixture at spontaneous breathing. This type of anesthesia eliminates or significantly reduces the need to use complex combinations of potent pharmacological agents, characteristic of intravenous anesthesia and is characterized by much greater maneuverability for the anesthesiologist and more fine control depth of anesthesia.

Myth: “If possible, it is better to do without anesthesia. At least during dental procedures."

In fact: There is no need to be afraid of treating a child’s teeth under general anesthesia. If the treatment is associated with surgery (tooth extraction, abscesses, etc.), with a large volume of dental procedures (treatment of multiple caries, pulpitis, periodontitis, etc.), with the use of equipment and tools that can frighten the child, without Anesthesia is indispensable. In addition, this allows the dentist to concentrate on the treatment, without being distracted by calming the little patient.

However, the use of general anesthesia for dental treatment Children have the right only to a clinic that has a state license for anesthesiology and resuscitation, which is equipped with all the necessary equipment and has a staff of qualified, experienced pediatric anesthesiologists and resuscitators. It won't be difficult to check this.

Myth: “Anesthesia damages brain cells, causing impairment of cognitive functions in a child, reducing his school performance, memory and attention.”

In fact: . And although in most cases this does not affect memory, it is with carrying out general anesthesia Cognitive impairment is often associated in children and adults who have undergone major, time-consuming surgery. Cognitive abilities usually recover within a few days after anesthesia. And here a lot depends on the skill of the anesthesiologist, on how adequately he administered the anesthesia, as well as on the individual characteristics of the little patient.

Should you panic when you hear the word “anesthesia”? Should I be afraid of general anesthesia, and if so, what is its danger for the child? What could be the consequences of such anesthesia? Let's find out.

General anesthesia for a child

The baby will undergo surgery under general anesthesia. But just the thought of anesthesia makes you shiver. This happens to many parents. And all because a lot of rumors and conjectures are swarming around general anesthesia. It's time to find out once and for all which of this is true and which is an absolute myth.

What are the dangers of general anesthesia for a child?

Many parents believe that general anesthesia is very dangerous for a child, but they don’t know why. The main fear is that the baby will not wake up after surgery. Such cases do occur - in one situation out of a hundred. And as a rule, death It is in no way connected with anesthesia. In the vast majority of such cases, death occurs as a result of the operation itself.

So what is the danger of general anesthesia for a child? We can talk about the negative only in the context of contraindications. The doctor is obliged to analyze them thoroughly. And only after analysis the doctor makes a decision about whether there is urgency under general anesthesia or not. As a rule, extensive anesthesia is never prescribed unnecessarily. Especially for children.

To perform general anesthesia, the doctor mandatory must obtain parental permission. But before you refuse him this, think about it. Many operations on the younger generation are performed under general anesthesia. This is necessary in order to avoid psycho-emotional consequences.

The main purpose of anesthesia is to save the child from having to attend his own operation.

Local anesthesia will allow the baby to see blood, open wounds and a lot of other unsightly things. How this will affect the fragile psyche is difficult to predict.

Consequences of general anesthesia for children

General anesthesia sometimes entails unpleasant consequences for children. The attending physician will definitely warn you about them before the operation. Based on this information, mom and dad will decide whether extensive anesthesia is necessary.

How does general anesthesia affect a child? How can it manifest itself after surgery?

• Headache,
• dizziness,
• panic attacks,
• memory loss,
• convulsions,
• heart failure,
• kidney problems and liver problems.

All of the listed consequences sometimes have no place at all in the life of a small patient. Some people experience short-term headache. Some people experience seizures a few days after surgery calf muscles. This does not mean that all of the listed conditions will “attack” the child without fail and en masse, no. It's just possible consequences extensive anesthesia. They may not exist at all. This is why it is so important to trust your doctor. Hardly good specialist will advise the child on what is not necessary. And if there is a need, then it is probably much more acute than all the consequences combined.