Abstract
Paediatric patients display different pharmacokinetic and pharmacodynamic responses to anaesthetic drugs. These drugs can be used safely in neonates and children if their altered pharmacology is understood. The physiological differences in each body system that lead to this altered drug handling are described. They include the staged maturation of hepatic and renal elimination pathways, depending on gestational and post-natal age. Body water forms a greater proportion of the neonate than the adult and these differences are illustrated. The commonly used classes of anaesthetic drugs are discussed in more detail, including induction agents, volatile agents, opioids, neuromuscular blocking agents, non-steroidal anti-inflammatory drugs and local anaesthetics. Pharmacological handling at different ages and dosing implications are covered.
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