Pediatric Anaesthesia Article

Question 1

Why is pediatric anesthesia for kittens often necessary?

Answer 1

It’s often required for pre-pubertal neutering, surgeries, or diagnostic tests.

Question 2

What unique complications may arise during pediatric anesthesia?

Answer 2

Complications can include difficult vascular access, hypothermia, bradycardia, and hypoglycemia.

Question 3

What life stage is considered ‘neonatal’ for kittens?

Answer 3

Neonatal is from birth up to 4 weeks.

Question 4

At what age range are kittens classified as ‘pediatric’?

Answer 4

Kittens are considered pediatric between 4 weeks and 6 months.

Question 5

Why are pediatric patients at a higher risk of hypothermia during anesthesia?

Answer 5

Their larger surface area-to-body volume ratio, low body fat, and reduced shivering efficiency increase hypothermia risk.

Question 6

What are typical temperature ranges for neonatal kittens in the first week?

Answer 6

95–98°F (35–36.6°C).

Question 7

What is the primary method for warming pediatric patients during anesthesia?

Answer 7

Using devices like the ‘Bair Hugger’ or warm blankets and bottles.

Question 8

Why is an adult-sized respiratory circuit unsuitable for pediatric patients?

Answer 8

It creates excessive dead space and resistance, making breathing difficult for small animals.

Question 9

What type of breathing circuit should be used for pediatric patients?

Answer 9

A non-rebreathing or pediatric breathing circuit.

Question 10

Why might vascular access be challenging in kittens?

Answer 10

Due to their small size, making veins hard to locate and access.

Question 11

What alternative method can be used if vascular access is difficult in kittens?

Answer 11

Intraosseous (IO) catheterization in the femur or other bones.

Question 12

Why is intubation challenging for small kittens?

Answer 12

Cuffed tubes may be too large, so small diameter uncuffed tubes are used.

Question 13

How do kittens’ cardiovascular responses differ from adults?

Answer 13

They rely primarily on heart rate rather than other mechanisms to increase cardiac output.

Question 14

Why should drugs causing bradycardia be avoided in young kittens?

Answer 14

Bradycardia can lead to decreased cardiac output, hypoxia, poor perfusion, and hypotension.

Question 15

What is a common risk associated with respiratory depression in kittens?

Answer 15

Risk of apnea, atelectasis, and hypoxia due to immature lungs and high oxygen demands.

Question 16

Why do pediatric kittens require supplemental oxygen during anesthesia?

Answer 16

They have higher oxygen demands and a limited ability to adjust to low oxygen levels.

Question 17

At what age are kitten kidneys functionally mature?

Answer 17

Kidneys are functionally immature until after birth but fully anatomically developed.

Question 18

Why should fluid rates be carefully adjusted for pediatric patients?

Answer 18

Due to their high body water content and limited ability to handle fluid changes.

Question 19

How can hydration be monitored in pediatric patients?

Answer 19

By measuring body weight on a gram scale two or three times a day.

Question 20

At what age does the kitten liver start functioning like that of an adult?

Answer 20

Around 3 months old.

Question 21

Why are young kittens prone to hypoglycemia?

Answer 21

They have reduced glycogen synthesis and storage.

Question 22

How long should pediatric patients fast before anesthesia?

Answer 22

2–3 hours for kittens aged 6–8 weeks.

Question 23

What should be monitored during anesthesia to detect hypoglycemia?

Answer 23

Blood glucose levels.

Question 24

What is the recommended pre-anesthetic blood glucose level for a 4-week-old kitten?

Answer 24

About 6.1 mmol/L (110 mg/dL).

Question 25

Why should NSAIDs be avoided in kittens under 6 weeks?

Answer 25

Due to potential renal impact on immature kidneys.

Question 26

What risk is associated with phenothiazines in kittens under 12 weeks?

Answer 26

They may cause peripheral vasodilation and central nervous system depression.

Question 27

Why are alpha-2 agonists used cautiously in kittens under 8 weeks?

Answer 27

They can cause profound bradycardia.

Question 28

What should be prioritized in anesthesia for pediatric patients?

Answer 28

Adjusting drug protocols and monitoring to accommodate the needs of young animals.

Question 29

What is the primary concern for the haematopoietic system in young kittens?

Answer 29

They are less tolerant of blood loss due to an ongoing transition in hemoglobin types.

Question 30

What is the guideline for blood loss in pediatric surgery?

Answer 30

Blood loss should be limited to approximately 4%.

Question 31

How do kittens differ from adults in response to volume depletion?

Answer 31

They lack the adult responses to manage volume changes effectively.

Question 32

What anesthetic drugs are recommended for kittens?

Answer 32

Drugs that are reversible or partially reversible and can be dosed to effect.

Question 33

Why is careful dosing required for anesthetic drugs in young patients?

Answer 33

Due to altered renal and hepatic metabolism in pediatric animals.

Question 34

What is the concern with shivering as a temperature control method in kittens?

Answer 34

Shivering is less efficient in young animals and can be altered by anesthesia.

Question 35

What are some supplementary warming options during pediatric anesthesia?

Answer 35

Hot air blankets, electrical warming devices, and warm water bottles.

Question 36

What is a critical factor for oxygen supply in kittens during anesthesia?

Answer 36

Providing oxygen prevents apnea and compensates for higher oxygen needs.

Question 37

Why is post-anesthetic feeding important for kittens?

Answer 37

To prevent hypoglycemia by providing immediate energy.

Question 38

What are the recommended sites for IO catheterization in kittens?

Answer 38

Greater trochanteric fossa, ilium wing, humerus, or tibial tuberosity.

Question 39

Why is there a greater risk of hypercapnia in kittens during anesthesia?

Answer 39

Due to respiratory muscle fatigue and increased resistance in breathing circuits.

Question 40

Why is slow warming preferred over rapid warming in anesthetized kittens?

Answer 40

To avoid excessive metabolic and respiratory demands.

Question 41

What is an ideal blood glucose level before anesthesia for a kitten?

Answer 41

Close to 6.1 mmol/L (110 mg/dL), with dextrose if below 4.5 mmol/L (80 mg/dL).

Question 42

Why should drug protocols be adjusted based on individual kitten needs?

Answer 42

Due to variations in metabolism, hydration, and tolerance in young patients.