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Module 11 · Anaesthesia Blueprints

Paediatric anaesthesia: exam notes and MCQs

Prepare paediatric anaesthesia for postgraduate anaesthesia examinations with structured notes, exam-style questions and referenced explanations from standard textbooks and current guidelines.

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Exam notes in this module

Paediatric anaesthesia: physiology and practice
Anatomical and physiological differences, standard values, equipment and fluids.
Neonatal surgical emergencies
Tracheo-oesophageal fistula, congenital diaphragmatic hernia, abdominal wall defects and pyloric stenosis.
The paediatric airway and congenital syndromes
How the child's airway differs, syndromes that predict difficulty, and a safe strategy for the difficult paediatric airway.

Sample questions

Q1. According to Armitage's regimen for caudal block in children, which volume of local anaesthetic is expected to produce a block up to at least the mid-thoracic dermatomes?

  1. 0.5 mL/kg
  2. 0.75 mL/kg
  3. 1.0 mL/kg
  4. 1.25 mL/kg
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Answer D: 1.25 mL/kg

Armitage's volume scheme, still regarded as the most dependable: 0.5 mL/kg blocks all sacral dermatomes, 1.0 mL/kg blocks sacral and lumbar dermatomes, and 1.25 mL/kg reaches at least the mid-thoracic level.

Exam style: NEET-SS Anaesthesia

Q2. The MAC of volatile anaesthetics in children is HIGHEST at:

  1. Preterm neonates
  2. Term neonates (0–1 month)
  3. 1–6 months of age
  4. Adolescence
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Answer C: 1–6 months of age

MAC is lowest in the preterm neonate, increases by about 30% from birth, and peaks between 1 and 6 months of age; infants have a higher MAC than older children and adults, after which MAC declines with age.

Exam style: NEET-SS Anaesthesia

Q3. Cole's formula for the internal diameter (mm) of an UNCUFFED endotracheal tube in a child is:

  1. (age/4) + 3
  2. (age/4) + 4
  3. (age/2) + 4
  4. (age + 16)/2
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Answer B: (age/4) + 4

Cole's formula: ID (uncuffed) = (age/4) + 4 mm. For cuffed tubes, use (age/4) + 3.5 mm (Motoyama/Khine). Confirm with an air leak at 20–25 cmH₂O (uncuffed) or appropriate cuff pressure (< 20 cmH₂O).

Exam style: AIIMS INI-SS

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