Regional Anesthesia
1. Large prospective studies indicate that regional anesthetics have a high degree of safety and efficacy in pediatric patients, and can be used for intraoperative anesthesia, postoperative analgesia, and for a…
Developmental Pharmacology
1. Pediatric responses to drugs are determined by a large number of factors that change independently of one another during growth and development. 2. Children aged less that 12 months may have…
The Body Cavity and Wall
1. The septum transversum forms in the neck from the third, fourth, and fifth cervical myotomes and “descends” with the heart into the developing pleural cavity, subsequently separating into three layers….
The Foregut and Chest
1. A wide variety of disorders, with common as well as unique management principles, arise from the organs of the foregut. 2. These disorders are often associated with congenital anomalies and/or prematurity….
Pediatric Pain Management
1. The undertreatment of pain in children remains a problem. This is because pain and pain management are difficult problems made more complex by the ever changing physical and psychological states…
Fundamental Differences between Children and Adults
1. Pediatric anesthesiologists have long recognized that pharmacologic and physiologic calculations are larger on a “per kg” basis for infants and children than for adults. 2. Using the kg3/4 calculation, metabolic oxygen…
Trauma and Casualty Management
1. Age and sex are the most important factors influencing the patterns of injury in pediatric trauma. 2. Because their cranial bones are thinner and their head-to-body ratio is greater, the contents…
The Urogenital System
1. The development of the urogenital system can conceptually be divided into its urinary portion and genital portion. 2. Specific anesthetic considerations for patients with Wilms tumor include a thorough imaging evaluation…
Vascular Biology and Vascular Anomalies
1. Development of the vascular system starts in early embryogenesis. • Mesenchymal cells develop into hemangioblasts, some of which become angioblasts. • The formation of de novo vessels is referred to as vasculogenesis;…
The Central Nervous System: Pediatric Neuroanesthesia
1. The Monro–Kellie hypothesis states that the sum of all intracranial contents—brain and interstitial fluid (80%), cerebrospinal fluid (CSF; 10%), blood (10%)—remains constant. 2. Maintenance of cerebral perfusion pressure (CPP) is essential…
