Pediatric Anesthetic Techniques: Intravenous Induction

Intravenous Induction

The same induction sequence can be used as in adults: propofol (2–3 mg/kg) followed by a non-depolarizing muscle relaxant (eg, rocuronium, cisatracurium, atracurium) or succinylcholine. We recommend that atropine be given routinely prior to succinylcholine. The advantages of an intravenous technique include availability of intravenous access if emergency drugs need to be administered and rapidity of induction in the child at risk for aspira-tion. Alternatively (and very commonly in pediatric practice), intubation can be accomplished with the combination of propofol, lidocaine, and an opiate, with or without an inhaled agent, avoiding the need for a paralytic agent. Finally, paralytic agents are not needed for placement of LMAs, which are com-monly used in pediatric anesthesia.