Canadian Journal of Anesthesia, Vol 9, 220-233, Copyright © 1962 by Canadian Anesthesiologists' Society

Hazards of Anaesthesia for the Burned Child

¹ Anaesthetist-in-Chief, The Children's Hospital, and Assistant Professor of Surgery (Anaesthesia), Department of Surgery, University of Manitoba, Winnipeg, Manitoba

An outline is given of the clinical course and pathological processes involved in severe burns in children. The anaesthetist can and should help at every stage. He should advise and help with resuscitation, in the care of the airway and oxygen therapy, in the use of drugs for pain relief, for sedation, and for the control of vomiting and anorexia. He should know the place of hypnosis in treating burned children. Case histories are presented from a seven-year review of deaths occurring in burned children at The Children's Hospital, Winnipeg. The extent and severity of the pathological changes in burned children can be easily underestimated. The problems of general anaesthesia are described, especially the high incidence of cardiac arrest reported in children with burns of long duration. A review of the literature on this aspect of the problem, together with personal experience, leads to some suggested precautions. These include the pre-operative estimation of blood volume, if feasible, radiography of the chest, and electrocardiography. During induction of anaesthesia succinylcholine is better avoided and thiopental given slowly and in small doses. Extreme care and gentleness are necessary to assure the safety of such children.

Note:

Presented in condensed form at the Western Division Meeting of the Canadian Anaesthetists Society, held at Edmonton, Alberta, March 1–3, 1962.