This paper will attempt to show how a sound knowledge of anatomy, physiology, pharmacology and psychology of infants and children and how they differ from adults helps to improve their care during anaesthesia and the perioperative period. A baby can be taken from the parent without undue distress up to 6 to 7 months of age while an older infant or young child will become very distressed and hence they should be accompanied by a parent to induction of anaesthesia provided the parent doesn't exhibit undue anxiety. In such cases it may be better to give the child some premedication.
Older children can cope but many like to be accompanied by a parent.
Sometimes children, particularly boys of 8 to10 years old, appear well adjusted when seen beforehand but show signs of extreme apprehension when they reach the induction room - this presents as almost invisible veins so that venepuncture is difficult. Again, premedication should be considered. It may sting but it usually has an effect within about 10 minutes. The increased ventilation through crying does not necessarily speed induction - the increased uptake merely compensates for the drug which has been redistributed to muscle. It is often said that children are like small adults.