Pediatric and Neonatal Anesthesia Flashcards

What is the primary mechanism of heat loss in neonates during anesthesia?

Answer: Radiation

Radiation accounts for the largest proportion of heat loss in neonates due to their high surface-area-to-volume ratio.

Which volatile anesthetic is associated with the highest risk of laryngospasm in pediatric patients?

Answer: Desflurane

Desflurane is the most pungent volatile agent and is associated with the highest incidence of airway reactivity, coughing, and laryngospasm in children.

A term neonate requires emergency laparotomy. What is the most appropriate ETT size?

Answer: 3.0–3.5 mm uncuffed

A term neonate typically requires a 3.0–3.5 mm uncuffed (or microcuffed) endotracheal tube.

At what postconceptional age is it generally safe to perform elective surgery without overnight monitoring for apnea in a premature infant?

Answer: 56 weeks

Most guidelines recommend 56–60 weeks postconceptional age before elective surgery without mandatory overnight apnea monitoring, though thresholds vary by institution.

Which induction technique is preferred for a child with a suspected difficult airway and a full stomach?

Answer: Awake fiberoptic intubation

Awake fiberoptic intubation preserves spontaneous ventilation and airway reflexes, making it the safest choice when both airway difficulty and aspiration risk coexist.

What is the correct formula for estimating blood volume in a preterm neonate?

Answer: 90–100 mL/kg

Preterm neonates have a blood volume of approximately 90–100 mL/kg, compared to 80–90 mL/kg in term neonates.

Which physiological feature of the neonate makes them particularly vulnerable to opioid-induced respiratory depression?

Answer: Immature blood-brain barrier with higher CNS penetration

The immature blood-brain barrier in neonates allows greater CNS penetration of opioids, increasing sensitivity to respiratory depression.