THE POPULATION IN THE DEVELOPING WORLD CONTINUES TO GROW while world demographics trend toward an aging population in an urbanized, developed world. Children, many orphaned by the ravages of war, human immunodeficiency virus (HIV) infection, and famine, constitute more than…
THE RABBIT HOLE THAT IS THE PERIOPERATIVE ENVIRONMENT is not well understood by the majority of our general pediatric colleagues. Similarly, the rabbit hole of the primary care clinic or the pediatric inpatient ward is not well understood by the…
VASCULAR CANNULATION IS AN IMPORTANT PROCEDURE in the anesthetic and perioperative management of children. Its routine use was introduced in the 1950s. The indications are to provide routes to administer fluids, drugs, and blood products, monitor cardiopulmonary function, and access…
The Evolution of Pediatric Sedation and the Anesthesiologist's Role Perhaps more than ever, the care of children in the hospital setting requires the provision of sedation in a timely and effective manner. Many children who require an imaging procedure or…
EMERGENCE FROM ANESTHESIA IN CHILDREN differs substantially compared with adults. The process is multifaceted, dependent on the nature of the surgery, patient characteristics, and the type of anesthesia administered. In young children, emergence from inhalational agents can be quite rapid…
the approach to providing anesthesia outside the operating room (OR) for children (also known as “non–operating room anesthesia” [NORA] or “Off-site Anesthesia”) varies greatly among health care organizations and even from one anesthesia provider to another. Because of its very…
THE PRACTICING PEDIATRIC ANESTHESIOLOGIST is involved in chronic pain in one of three main venues: a child who is scheduled for a procedure, in consultation, or during acute pain management rounds. In this chapter, we focus on the essential approaches…
the practice of pain management in children continues to advance. Since the early 1980s, clinicians have recognized that neonates and infants experience pain and process those learning experiences. Research has demonstrated long-term adverse consequences of unrelieved pain, including harmful neuroendocrine…
peripheral nerve blocks are frequently performed in children to provide anesthesia or analgesia during the perioperative period. Success depends on the ability to accurately place the needle—and thereby the local anesthetic—close to the target nerve without causing injury to the…
ANESTHESIOLOGISTS COMMONLY PROVIDE CARE TO CHILDREN who have suffered traumatic injuries of varying complexity. They range from the healthy, older child with an isolated elbow fracture to the infant with a life-threatening epidural hematoma. The anesthesiologist should view the management…