Pediatric clinics of North America
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Preoperative evaluation and preparation are directed toward minimizing the intrinsic risks of anesthesia and surgery by having the child in the healthiest possible condition prior to surgery. The pediatrician can contribute to this goal by understanding the effects of general anesthesia on the physiology of children. ⋯ The preoperative evaluation is designed to ensure that the child's preoperative needs may be met by providing the anesthesiologist both qualitative and quantitative information regarding the child's state of health and disease. The relationship between the child, parents, and pediatrician places the pediatrician in an ideal position to prepare families for their children's surgical experience.
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This article addresses the preoperative fast in the context of its historic background, the physiology of gastric emptying, and recent clinical studies. A rationale is developed for minimizing the traditional preoperative fasting interval for elective surgery. The timing and the necessity for patients to resume ingesting clear liquids in the postoperative period is also explored.
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Pediatr. Clin. North Am. · Feb 1994
ReviewThe night after surgery. Postoperative management of the pediatric outpatient--surgical and anesthetic aspects.
Outpatient or "ambulatory" anesthesia and surgery has revolutionized the way surgery is practiced in the United States. Safe, reliable, inexpensive, and convenient outpatient surgery is an attractive option for parents, children, health care providers, and insurers.
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Pediatr. Clin. North Am. · Feb 1994
ReviewAnesthetic implications of an upper respiratory infection in children.
Pediatricians and pediatric anesthesiologists are frequently confronted with the dilemma of a child scheduled for elective surgery with or recently recovered from an upper respiratory tract infection. Modifications of routine anesthetic practice may decrease but not eliminate risks of associated complications. Guidelines for the evaluation and triage of these children are presented.
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Safe sedation of a pediatric patient requires a thorough knowledge of the pharmacokinetics and pharmacodynamics of the drugs used to sedate the patient and the skills necessary to deal effectively with potential adverse events as a result of the sedation. The Sedation Guidelines of the American Academy of Pediatrics are reviewed. Emphasis is placed on monitoring and appropriate selection of drugs.