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Anesthesia for ex-premature infants and children

Author
Leila M Pang, MD
Section Editor
Lena S Sun, MD
Deputy Editor
Marianna Crowley, MD

INTRODUCTION

Prematurity is defined as a birth that occurs before 37 completed weeks (less than 259 days) of gestation. In ex-premature infants and children, there are high rates of long-term neurodevelopment impairment and chronic health problems, and an increase in conditions that require surgery and anesthesia compared with full-term infants.

Ex-premature infants and children include a heterogenous population, ranging from healthy children born at 36 weeks gestation to formerly extremely premature children with significant medical issues that affect anesthetic care.

Outside of the neonatal period, the most common surgical procedures performed in these children are inguinal hernia repair and ophthalmologic procedures (often due to underlying retinopathy of prematurity). After even minor surgical procedures, ex-premature infants are at higher risk for postoperative apnea than infants born at term.

This topic will discuss the anesthetic management of children who undergo surgical procedures outside of the neonatal period. Neonatal management, the acute and chronic complications of prematurity, and medical care of formerly preterm infants are discussed separately. (See "Care of the neonatal intensive care unit graduate" and "Management of bronchopulmonary dysplasia" and "Short-term complications of the preterm infant" and "Long-term complications of the preterm infant".)

TERMINOLOGY

In this topic, we follow the American Academy of Pediatrics policy statement on the recommended terminology regarding the length of gestation and age for neonates [1], as follows:

                 

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Literature review current through: Nov 2016. | This topic last updated: Tue Mar 29 00:00:00 GMT+00:00 2016.
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