Seminars in pediatric surgery
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Recent developments in pharmacology have offered new and broader options to the anesthesiologist caring for pediatric patients. Many new drugs do not have specific indications for use in the pediatric population, but clinical studies have examined the utility and cost-effectiveness of some of these agents. ⋯ The clinical pharmacology of several new nondepolarizing muscle relaxants, and the recent controversy with regard to the use of succinylcholine also are presented. New drugs used in topical and regional anesthesia as well as options for anti-emetic therapy are discussed.
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Semin. Pediatr. Surg. · Feb 1999
Sharing the pediatric airway: issues between the surgeon and the anesthesiologist.
During surgical procedures, "ownership" of the patient's airway is often controversial. Communication between the anesthesiologist and the surgeon is critical. The author discusses several medical scenarios in which the anesthesiologist and surgeon must share the patient's airway. Strategies are outlined that can be used by both surgeon and anesthesiologist to ensure optimal outcome for patients.
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Semin. Pediatr. Surg. · Feb 1999
Sedation and anesthesia outside the operating room: answers to common questions.
In recent years, practitioners have recognized the importance of providing comfort to children and have increased their use of analgesics and anxiolytics during painful medical procedures. In this article, the author reviews commonly asked questions regarding administering sedation to children for painful procedures outside the operating room. Current safety guidelines are reviewed, as well as qualifications of personnel performing sedations, contraindications to sedation, fasting guidelines before sedation, and common sedation techniques.
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Semin. Pediatr. Surg. · Feb 1999
Assessment of pediatric patients for general anesthesia: the child with an upper respiratory infection and the ex-premature infant.
There are two types of patients that commonly lead surgeons and anesthesiologists into discussions relating to the possible cancellation or postponement of a minor pediatric surgical procedure; the child with a recent upper respiratory infection, and the patient who was born prematurely. Current opinion of the risks of anesthesia in such patients and the factors that influence perioperative course are reviewed, and a plan of management is suggested.
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There is increasing evidence that involvement of pediatric anesthesiologists in the perioperative care of infants and children can positively impact outcome. Considerable data have emerged in the past several years that clearly show that infants and small children experience untoward events at a much higher rate than do older children and adults. Herein the author presents some of this literature as well as data suggesting that anesthesiologists with interest and additional training in the care of infants and children can improve anesthesia outcomes. Even in these days of cost containment, it makes sense to provide the best pediatric team to care for the pediatric patient during the perioperative experience.