The Star Malaysia
They put children to sleep
Children are not just small adults, hence the need for paediatric anaesthesiologists when surgery is required for kids.
IF you are looking for an expert to provide anaesthesia for your child in the operating theatre, there is no better person than a paediatric anaesthesiologist.
They work with children before, during and after surgical procedures.
As in all anaesthetic practice, paediatric anaesthesiologists provide a balanced mixture of anaesthesia, analgesia and muscle relaxant, depending on the nature of surgery.
They monitor and ensure that vital signs such as blood pressure, heart rate and oxygenation remain stable throughout surgery.
They take care of the pain and fluid requirements of the child as well during and after surgery.
They put children at ease before any surgical procedures as well as discuss all aspects of the procedure and anaesthetic plan with the parents.
They play the role of perioperative physicians who take care of children – ranging from the newborn period, infants and toddlers, and through the teenage years.
Some paediatric anaesthesiologists also work in paediatric intensive care, together with paediatric intensivists, to provide the best of care to critically ill children.
A paediatric anaesthesiologist is a fully trained anaesthesiologist who has undergone further sub-specialisation training in paediatric anaesthesia.
In Malaysia, this training is of three years duration, with a combination of extensive local and overseas training covering all core surgical and medical aspects from various disciplines.
The Paediatric Institute, Hospital Kuala Lumpur, is the main national referral centre for paediatric surgical and medical related problems. Trainees in paediatric anaesthesia would be trained and supervised by a group of experienced and dedicated consultant paediatric anaesthesiologists and consultant paediatric intensivists.
Children are not just small adults. They have various differences in terms of physiology, anatomy and pharmacokinetics.
Providing anaesthesia for children is more challenging and complex compared to adults. It requires special skills, knowledge and confidence to provide safe anaesthesia for children.
Many infants and children who require surgery have very complex medical problems – ranging from heart, lungs, brain and bones to various syndromes that have a lot of significant anaesthetic risks.
Paediatric anaesthesiologists are best qualified to evaluate these complex problems and plan a safe anaesthesia technique for these infants and children.
And since most children won’t be able to answer medical questions, it can be very difficult to get their cooperation during their medical examination. Paediatric anaesthesiologist are trained to tease out such information from children in a manner that makes them relaxed and comfortable.
Apart from providing anaesthesia for children in the operating theatre, paediatric anaesthesiologists are sought to provide sedation outside the operating theatre for MRI, CT scans, and simple procedures in the ward under Monitored Anaesthesia Care (MAC).
Paediatric anaesthesiologists also play an important role in pain control for children.
They provide various techniques of pain relief such as epidural, regional anaesthesia, nerve block and intravenous infusion of opioids as a part of a multimodal analgesia regimen, particularly in dealing with acute pain after surgery.
They are also expected to manage the paediatric airway. Airway management in neonates and infants can be very difficult and challenging.
These children can present with various anatomical defects, congenital anomalies and syndromes that are associated with difficult mask ventilation, difficult intubation, and some may even require combined care with paediatric respiratory and ENT surgeons.
Apart from managing the airway, paediatric anaesthesiologists also assist in intravenous cannulation (and this can be very difficult in smaller babies, infants and children).
Paediatric anaesthesiologists are experts in trauma and resuscitation. More often, they work together with the paediatric surgical and medical team resuscitating the sick child in the ward and paediatric intensive care.
So, if surgery is planned for your child and he/she is referred to a paediatric anaesthesiologist, rest assured that your child is in the best of hands, and care.
Dr Sivaraj Chandran is undergoing his subspecialty training in paediatric anaesthesiology at the Institut Pediatrik, Hospital Kuala Lumpur.