Neonates, as anesthesia patients, require special attention. Though they appear to be a miniaturisation of adults, their physiology is not exactly so. There is a wide difference in the physiological requirements of neonates and their adult counterparts. Anesthetic management of neonatal surgeries require a precise understanding of the transitional physiology that exists in neonates and a sound knowledge of the pathophysiology of the surgical condition.

A 2 day old baby weighing 1.5 kg, diagnosed with mal rotation and partial volvulous, was posted for Ladd's procedure.

A 2 day old baby weighing 1.2 kg, diagnosed with anobulbar fistula, was posted for colostomy.

An 18 hours old baby weighing 2 kg, diagnosed with anocutaneous fistula, was posted for colostomy.

ll our patients were premedicated with atropine. Induction was done with Sevoflurane and fentanyl, intubated and then paralysed with Atracurium. Meticulous calculation of doses of all anesthetic drugs and analgesics was done. Capillary blood glucose was monitored every 30 minutes. Adequate intraoperative analgesia was given with fentanyl and postoperative analgesia was given with paracetamol suppository. Ambient room temperature was maintained. Body temperature was monitored with nasopharyngeal probe. Patient was covered with warm drapes. Warm IV fluids were infused and peritoneal wash was given with warm saline. Maintainance fluid was given at 4 ml per kg. Third space loss was replaced. Each ml of blood loss was replaced with 3 ml of crystalloids. As a result of these measures, we were able to successfully extubate all our patients on table. Post extubation all patients maintained adequate spontaneous ventilation with a normal saturation and heart rate.

Neonates are not tiny adults. Their unique physiology poses many challenges to the anesthesiologist at various levels. These challenges can be successfully managed with vigilant monitoring and intensive care.