Sen Indu, Dave Nandini, Bhardwaj Neerja, Juwarkar Chitra, Beegum Shamshad
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Anaesthesia, NH SRCC Children's Hospital, Mumbai, Maharashtra, India.
Indian J Anaesth. 2021 Jan;65(1):17-22. doi: 10.4103/ija.IJA_1445_20. Epub 2021 Jan 20.
Paediatric anaesthesia is an upcoming speciality which is gaining wide interest and can be a career choice for the new trainees. The need to develop paediatric anaesthesia as a speciality was realised with the progress in the field of paediatric surgery. The profile of the 'patient' encountered by a paediatric anaesthesiologist spans from an extremely premature neonate on the fringes of survival, to a full-grown adolescent equivalent to an adult. Perioperative morbidity and mortality are 2-3 times higher in infants and neonates compared to adults particularly in middle and low-income countries. The anatomical, physiological, pharmacological variations and presence of congenital cardiac, pulmonary and metabolic diseases in young children make perioperative management challenging. Special expertise and training are required for anaesthetic management of these preverbal children. In India, 3-years DM and 1-year Fellowship courses in paediatric anaesthesia are now available for specialisation. An ideal paediatric anaesthesia training centre should have substantial paediatric and neonatal patient load with exclusive intensive care facility. Paediatric anaesthesiologists, having knowledge of several facets of paediatrics and anaesthesia are capable of coordinating with health care professionals performing procedures outside the operating room. Paediatric anaesthesia, as a career thus offers a great opportunity to enhance quality and safety of anaesthesia in this high-risk surgical population. Persistent coordinated team efforts improve patient outcomes, reduce stress at work and increase job satisfaction.
小儿麻醉是一个新兴的专业领域，正受到广泛关注，对于新学员来说可能是一个职业选择。随着小儿外科领域的发展，人们认识到将小儿麻醉发展成为一个专业领域的必要性。小儿麻醉医生所面对的“患者”范围从濒临生存边缘的极早产儿到相当于成年人的青少年。与成年人相比，尤其是在中低收入国家，婴儿和新生儿围手术期的发病率和死亡率要高出2至3倍。幼儿的解剖、生理、药理学差异以及先天性心脏、肺部和代谢疾病的存在，使得围手术期管理具有挑战性。对这些尚不会说话的儿童进行麻醉管理需要特殊的专业知识和培训。在印度，现在有为期3年的小儿麻醉专科文凭课程和为期1年的进修课程。一个理想的小儿麻醉培训中心应该有大量的小儿和新生儿患者，并配备专门的重症监护设施。小儿麻醉医生了解小儿科和麻醉学的多个方面，能够与在手术室以外进行操作的医护人员进行协调。因此，小儿麻醉作为一种职业，为提高这一高风险手术人群的麻醉质量和安全性提供了绝佳机会。持续的团队协作努力可改善患者预后、减轻工作压力并提高工作满意度。
