Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Section I Basic sciences
- Section II Anaesthesia and peri-operative care for surgical specialties
- Chapter 7 Cardiothoracic cases
- Chapter 8 Colorectal cases
- Chapter 9 Upper gastrointestinal cases
- Chapter 10 Hepatobiliary and pancreatic cases
- Chapter 11 Endocrine cases
- Chapter 12 Vascular cases
- Chapter 13 Organ transplant cases
- Chapter 14 Otorhinology, head and neck cases
- Chapter 15 Paediatric cases
- Chapter 16 Plastic, reconstructive and cosmetic cases
- Chapter 17 Neurosurgery cases
- Chapter 18 Trauma cases
- Chapter 19 Orthopaedic cases
- Chapter 20 Urology cases
- Chapter 21 Bariatric cases
- Section III At a glance
- List of abbreviations
- Index
Chapter 15 - Paediatric cases
Published online by Cambridge University Press: 05 July 2014
- Frontmatter
- Contents
- List of contributors
- Foreword
- Section I Basic sciences
- Section II Anaesthesia and peri-operative care for surgical specialties
- Chapter 7 Cardiothoracic cases
- Chapter 8 Colorectal cases
- Chapter 9 Upper gastrointestinal cases
- Chapter 10 Hepatobiliary and pancreatic cases
- Chapter 11 Endocrine cases
- Chapter 12 Vascular cases
- Chapter 13 Organ transplant cases
- Chapter 14 Otorhinology, head and neck cases
- Chapter 15 Paediatric cases
- Chapter 16 Plastic, reconstructive and cosmetic cases
- Chapter 17 Neurosurgery cases
- Chapter 18 Trauma cases
- Chapter 19 Orthopaedic cases
- Chapter 20 Urology cases
- Chapter 21 Bariatric cases
- Section III At a glance
- List of abbreviations
- Index
Summary
Peri-operative care of paediatric patients presents unique challenges and opportunities for surgeons and anaesthetists to work synergistically. No subpopulation of patients is more heterogeneous with respect to physiology or spectrum of pathology.
Pre-operative
Having decided that the child before them requires an operation, surgeons must consider a number of areas peculiar to paediatric patients.
Need for general anaesthesia
Many procedures that would be done in adults under local anaesthesia, or with conscious sedation, cannot be achieved without general anaesthesia in children. Examples include MR imaging studies, GI endoscopies and most minor body surface surgery.
Assessment and optimisation
Most elective procedures in children are performed on a day case basis. Prudent selection and referral of patients who require pre-operative anaesthetic assessment for optimisation is critical, to avoid both unnecessary additional hospital visits and day of surgery cancellations.
Planned pre-operative admission
This is an indication for a detailed pre-operative anaesthesia assessment. The admission is likely a function of some combination of the magnitude of surgery, existing co-morbidity and the need for advanced post-op pain management modalities. Adequate time needs to be provided for optimisation of co-morbidities, and for the risks and benefits of anaesthesia and post-op pain management strategies to be presented and digested by the patient and family.
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- A Surgeon's Guide to Anaesthesia and Peri-operative Care , pp. 168 - 180Publisher: Cambridge University PressPrint publication year: 2014
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