Anesthesia of the Pediatric Patient

Puppies and kittens are considered neonates until 4 to 5 weeks of age and are classified as pediatric until about 12 weeks old. Anesthesia of neonates may be necessary for urgent correction of congenital anomalies or for necessary (not elective) diagnostics. Anesthesia of pediatric patients may be undertaken for elective early ovariohysterectomy or castration or for urgent procedures. The physiology of neonates and pediatric patients is different in several ways compared to adult dogs and cats. These differences need to be understood to formulate optimal anesthetic plans that incorporate balanced drug combinations and appropriate dosing of those drugs. Post operative analgesia for elective procedures and peri-operative analgesia for urgent situations are a very important part of the anesthetic experience because a life long oversensitivity (allodynia) can develop if pain in neonatal and pediatric patients is not managed appropriately. Studies in infant boys undergoing circumcision indicate that sensitivity to pain can be precipitated at even a few days of age if proper analgesia is not provided.