Why Is Neonatal Anaesthesia Such a Challenge?

Approximately 1.5 million neonates receive general anaesthesia each year for surgical procedures. Providing anaesthesia to neonates is not easy. Surgical procedures are often difficult and extensive, and the physiology of neonates makes respiratory and cardiovascular problems more frequent and life-threatening. The paper covers the changing concepts in neonatal anaesthesia, including recent studies that indicate that anaesthetic exposure could cause neuronal apoptosis in the developing brain. This could potentially influence the long-term developmental outcome, especially in infants requiring multiple surgical procedures. Respiratory and cardiovascular critical events, age-related differences of the pharmacokinetics of the drugs used for anaesthesia, as well as technical problems are also covered.