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…
ANESTHESIA
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…
Fetal Medicine and Anesthesia for Fetal Surgery
1. Fetal surgery is a rapidly evolving specialty with multiple fetal interventions being performed at different stages of pregnancy. 2. Pregnancy results in various anatomic and physiologic changes that impact anesthetic management….
The Hindgut
1. About 45% to 75% of ulcerative colitis patients eventually need surgery. Indications are divided into emergency, urgent, and elective. Emergency procedures are done for life-threatening complications of fulminant colitis unresponsive…
Gut Development: Surgical and Anesthetic Implications
1. The endoderm is divided into the foregut, midgut, and hindgut based on its vascular supply. 2. The tongue’s complex muscular and nervous innervation is a result of its development from branchial…
Abdominal Tumors
1. Liver tumors are rare in children and generally present as a painless mass. 2. Hepatoblastoma is the most common liver tumor in children. 3. Regional analgesia may be contraindicated in patients with…
