Principles of anaesthesia for term neonates

Anaesthesia for term neonates is associated with increased perioperative morbidity and mortality and as a result should be reserved for specialized paediatric centres. Neonatal systems are immature and are undergoing rapid growth and development. Neonates are uniquely different in how they respond to surgery, drugs and fluids and this response varies across the neonatal period. Many of the physiological differences in neonates are a reflection of their high metabolic rate, increase in oxygen demand and maturing organ systems. Due to the difficulties in studying this age group, a lot is still unknown about neonatal physiology and pharmacology.