PHYSIOLOGICAL AND ANAESTHETIC CONSIDERATIONS FOR THE PRETERM NEONATE UNDERGOING SURGERY

With improvements in healthcare, the survival of preterm babies has increased significantly and these preterm and ex-preterm babies often present for various surgical interventions. Previously, it was believed that due to the immaturity of the nervous system, these preterm babies do not experience or feel pain and consequently inadequate or no anaesthesia was administered to them. Recent work has shown that as early as the 13th to 20th week of gestation, there is perception of pain. Evoked potentials and cerebral glucose metabolism offer evidence of functional maturity and responses such as changes in pulse and blood pressure, crying, and grimacing have been quantified for circumcisions done without anaesthesia.