Chapter 1 – Normal Parameters for Pediatric Anesthesia

Abstract

This chapter provides the reader with an easy to reference tabular guide on a host of parameters relevant to the anesthetic care of children. The reader will find useful tables on normal hemodynamic parameters for children, sizing for equipment, analgesics and references for a variety of frequently used medications. The guide should serve to acquaint novice pediatric providers and may serves as a quick reference for all providers for less commonly administered agents.

Chapter 1 Normal Parameters for Pediatric Anesthesia

Adam C. Adler

As compared to adults, the “normal values” for a variety of physiologic measurements change throughout development. Listed in this chapter is a rough guide to be used in the anesthesia care of children. As always, the patients’ baseline and co-existing illness should be carefully considered when choosing a baseline.

Table 1.1 What are the normal values for heart rate in children?

Age	Awake heart rate	Asleep heart rate
Neonates <1 month	100–125	90–160
Infants (1–12 months)	100–180	90–160
Toddlers (1–2 years)	100–140	80–120
Preschool aged (3–5 years)	80–120	65–100
School aged (6–12 years)	75–120	60–90
Adolescents (12–15 years)	60–100	50–90

Table 1.2 What are the normal values for blood pressure in children?

Age	Systolic blood pressure (mmHg)	Diastolic blood pressure (mmHg)	Mean arterial pressure (mmHg)
Birth (LBW)	40–60	15–35	30–40
Birth (3 kg, term)	60–75	31–45	45–60
Neonates	65–85	35–55	45–60
Infants (1–12 months)	70–105	35-55	50–65
Toddlers (1–2 years)	85–105	40–65	50–60
Preschool aged (3–5 years)	90–110	45–70	60–70
School aged (6–12 years)	95–115	55–75	65–70
Preadolescents (10–12 years)	100–120	60–80	70–80
Adolescents (12–15 years)	110–130	65–85	75–85

Table 1.3 What are the normal values for respiratory rate in children?

Age	Respiratory rate (breaths/min)
Infants	30–55
Toddlers	22–35
Preschool aged	20–28
School aged	18–25
Adolescents	12–20

Table 1.4 What are normal values for estimated blood volume in children?

Age	Estimated blood volume (mL/kg)
Premature infants	100
Term neonates (<1 month)	90
1–12 months	80
Older children	75
Adolescents/Adults	70

Table 1.5 Basic equipment sizes in children

Age	ETT size	Laryngoscope	Oral airway	Mask size	BP cuff size
<1 month 3–5 kg	3.0	Miller 0–1	40	1	Neonate/#5
1–5 months 6–7 kg	3.0/3.5	Miller 1–1.5	40/50	1,2	Pediatric
6–11 months 10–11 kg	3.5/4.0	Miller 1–1.5	50/60	2	Pediatric
1–3 years 12–14 kg	4.0/4.5	Miller 1–1.5	60	3	Pediatric
4–5 years 15–18 kg	5.0/5.5	Miller 1.5–2	60	3,4	Pediatric
6–7 years 15–18 kg	5.5/6.0	Miller 1.5–2	60	4	Pediatric
8–9 years 19–23 kg	6.0/6.5	Miller 2, MAC 2	60/70	4	Pediatric
10–12 years 24–29 kg	6.0/6.5	Miller 2, MAC 2	70/80	4,5	Pediatric
>12 years 30–35 kg	5.5/6.0/6.5	Miller 2, MAC 3	70/80	5	Pediatric/small adult