[Neuroanesthesiology in the child weighing less than 10 kilos: use of Alfatesine combined with a morphinomimetic].

On the basis of the analysis of fifteen cases of children weighing less than ten kg, in a department of neurosurgery, the authors describe the use of Alfatésine by infusion in association with a morphinomimetic, a technique compatible with the existence of raised intracranial pressure. In view of the weight of the children, availability of a venous line represents a handicap and a danger to such an extent that the authors suggest limited assistance in the form of sedation by a halogenated agent, with the application of strict rules concerning dose and surveillance, bearing in mind its effects on intracranial pressure. The quality of anesthesia and of recovery is emphasised and the doses described. The effects of Alfatesine and of Fentanyl on intracranial pressure, cerebral metabolism and blood flow are reviewed. These favourable effects justify the use of Alfatesine in this context. One case of obvious overdose, responsible for delayed recovery, is discussed.