Pentothal Anesthesia in Infants and Children
MANY anesthesiologists consider intravenous pentothal sodium anesthesia to be contraindicated in children. Antipathy towards the agent arose with the early practice of using it in large doses and high concentrations. Since the limits of physiologic balance in infants and children during anesthesia are so narrow, only small deviations from the normal can be tolerated for any length of time.1 The overwhelming quantities of pentothal which were introduced directly into the circulation produced prompt respiratory and subsequent circulatory collapse. A few catastrophies tended to discourage further clinical trial.
When small calculated amounts of pentothal are used in conjunction with a few precautionary measures, this agent not only affords safe anesthesia2 but offers a technic which decreases operating time by permitting electrocoagulation and allows the anesthetist to be remotely placed from the patient. These factors are particularly advantageous during neurosurgical procedures and surgery of the head and neck.
The infant or child is intubated under ether anesthesia by the open drop method. In the average child a combination of morphine and atropine sulfate according to age and weight is sufficient premedication. In the excitable child, supplementary agents such as pentobarbital or rectal pentothal may be required for sedation to avoid the psychic trauma of ether induction. To force an anesthesia mask upon the face of a terrified child is cruel, especially when such action can be easily avoided by adequate premedication.
In early third plane of surgical anesthesia, an oro-tracheal tube is inserted into the trachea at least 2 cm, beyond . . .