Every year, over 13,000 kids require anesthesia as part of a procedure or surgery at BC Children’s Hospital. But to many, the very idea of being “under” anesthetic is a black-box mystery. To delve into the world of anesthesia—how it’s tailored for kids, and where the field is headed—we sat down with Dr. Simon Whyte, Head of Pediatric Anesthesiology.

1. How does anesthetic care differ between children and adults?

In so many ways! Children come in drastically different sizes and physiologies, from tiny newborns to adult-sized teenagers. We need to provide appropriate care for all of them. Kids also have much more limited respiratory reserve than adults, which means their oxygen levels drop much faster when under anesthetic. Because of factors like these, kids have much more variability in anesthetic drug dose requirements. Pediatric anesthesiology is very specialized, for good reason.

2. Can you tell us about some of the research team’s current investigations?

We’ve been investigating how genetic factors can help determine the amount of anesthetic children need. Specifically, we’re looking at how genetic variation in certain brain receptors might affect how anesthetic medicines work.

We’re also investigating whether allowing carbon dioxide levels to rise slightly within the body while under anesthesia may reduce the amount of anesthetic a child needs. Trying to achieve the depth of anesthesia you want with the least amount of drug is ideal, because it shortens the child’s recovery period.

3. When you think about the future of pediatric anesthesiology, what comes to mind?

Precision medicine hasn’t fully arrived in this field, but we’re working to change that. The investigation focused on individual genetic factors is a good example of this.

There’s also a lot to be said for global registries. In the field of anesthesia, refinements in care are mostly about improving already-good outcomes, or addressing rare occurrences, so big databases help us share and compare our learnings with others in our field.

Our team recently finished contributing data to a global study on breathing tubes in children. This multinational collaboration will have over 100,000 data points. It’s very inspiring, that we’re all working together. We have the same goal: improving anesthetic care for kids, everywhere.