Approaches to general anesthesia without airway intervention in the management of surgery in both term and preterm infant’s

Background: Anesthetic management in term and preterm infants poses unique challenges, especially when using general anesthesia without airway intervention. This approach aims to maintain effective anesthesia while minimizing respiratory compromise, which is crucial in neonates with underdeveloped respiratory systems. This review explores pharmacologic strategies, dosing considerations, and monitoring protocols to ensure safe anesthesia in neonatal surgeries. Special emphasis is placed on balancing anesthesia depth with respiratory preservation and adapting techniques based on the infant's gestational age. This approach could offer safer outcomes by reducing the risks associated with airway manipulation in this vulnerable population. Furthermore, we address the success rates, complications, and outcomes of general anesthesia without airway intervention. Aims and objectives: Neonatal general anesthesia without intubation is very much challenging but its feasible for low resource country with very much effective for difficult airway intubation as like neonate. Methods: This was a prospective type of observational study conducted in mymensingh medical college hospital, mymensingh, bangladesh from july 2022 to january 2024. Results: Total 1500 patients were included among them 300 were preterm neonates. The age ranges upto 2 months. Follow-up by clinical examination, pre-operative assesment and per-operative close monitoring by advanced pulse oximetry. 5 patients was expired during operative procedure due to severly ill patients. Conclusion: without airway intervention has revolutionized the management of anesthesia preterm and term infants, providing a reliable, safe, and effective method to treat in this age groups patients where neonatal airway intubation difficult and large number of neonates with very limited resources bangladesh like country. Its advantages may take it preferred approach for pediatric surgeons and anesthesiologist when dealing with this group of population.This article describes the common neonatal surgical emergencies and focuses on factors that affect the anaesthetic management of patients with these disorders without intubation.