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Smith's Anesthesia for Infants and Children E-Book

Smith's Anesthesia for Infants and Children E-Book

Etsuro K. Motoyama | Peter J. Davis | Franklyn P. Cladis

(2010)

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Book Details

Abstract

Smith’s Anesthesia for Infants and Children, 8th Edition, edited by Drs. Peter J. Davis, Franklyn P. Cladis, and Etsuro K. Motoyama, delivers all the state-of-the-art guidance you need to provide optimal perioperative care for any type of pediatric surgery. Now in full color throughout, it also features online access to an image and video library, including ultrasound-guided pediatric regional blocks, review-style questions, plus the complete fully-searchable text at expertconsult.com.

  • Get expert guidance from leading experts covering both basic science and clinical practice for every aspect of pediatric anesthesia.
  • Incorporate the latest clinical guidelines and innovations in your practice.
  • Find key facts fast with quick-reference appendices: drug dosages, growth curves, normal values for pulmonary function tests, and a listing of common and uncommon syndromes.
  • Access the complete contents and illustrations online at expertconsult.com – fully searchable!
  • Watch online video demonstrations of ultrasound-guided and conventional pediatric regional blocks, airway management, cardiac anesthesia, single-lung ventilation, neonatal surgery, and fetal surgery.
  • Gain new insight into today’s hottest topics, including sleep-disordered breathing, cuffed endotracheal tubes, premedication, emergence agitation, postoperative vomiting, and new airway devices.
  • Stay current with new chapters on ICU management, conjoined twins, and basic neonatal physiology, plus new coverage of pharmacology and monitoring techniques.
  • Get outstanding visual guidance with full-color illustrations throughout the book.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Smith’s Anesthesia for Infants and Children i
Copyright ii
Contributors iv
Contributors to the Supplemental Material ix
Foreword to the Eighth Edition xi
Preface xiii
Acknowledgments xv
Contents xvi
Supplemental Material xviii
Dedication xx
Abbreviations xxi
Part I: Basic Principles 1
Chapter 1: Special Characteristics of Pediatric Anesthesia 2
Perioperative Monitoring 2
Anesthetic Agents 3
Airway Devices and Adjuncts 3
Intraoperative and Postoperative Analgesia in Neonates 4
Regional Analgesia in Infants and Children 5
Fundamental Differences in Infants and Children 5
Summary 9
References 9
Chapter 2: Behavioral Development 10
Prenatal growth 10
Postnatal growth 11
Developmental assessment 11
Motor development 12
Language development 17
Cognitive development 17
Clinical relevance of growth and development in pediatric anesthesia 19
Chapter 3: Respiratory Physiology in Infants and Children 22
Development of the Respiratory System 23
Neonatal Respiratory Adaptation 25
Control of Breathing 27
Lung Volumes 41
Ventilation 54
Gas Diffusion 57
Pulmonary Circulation 57
Oxygen Transport 60
Ciliary Activity 66
Measurements of Pulmonary Function in Infants and Children 67
Special Considerations for Pediatric Lung Disease 74
Summary 79
References 79
Chapter 4: Cardiovascular Physiology 80
Fetal circulation 81
Transitional circulation 85
Myocardial performance 87
Developmental aspects of cardiomyocyte structure and function 95
Assessment of the cardiovascular system 100
Cardiac Magnetic Resonance Imaging 109
Effects of Anesthesia on the Cardiovascular System 112
Summary 115
References 115
Chapter 5: Regulation of Fluids and Electrolytes 116
Overview of anatomy and physiology 116
Maturation of renal function 124
Fluid and electrolyte needs in healthy infants and children 125
Dehydration in infants and children 126
Perioperative parenteral guidelines of fluids and electrolytes 129
Disorders of sodium metabolism 131
Disorders of potassium metabolism 136
Diuretic therapy 144
Anesthetic agents and the kidneys 146
Disorders of divalent ion metabolism 146
Summary 156
References 156
Chapter 6: Thermoregulation: Physiology and Perioperative Disturbances 157
Temperature Monitoring 158
Physiology of Thermal Regulation 159
Thermal Regulation in the Newborn 162
Heat Loss Mechanisms 163
Heat Generation 165
Effect of Anesthesia on Thermoregulation 168
Adverse Effects of Hypothermia 174
Prevention of Hypothermia 176
Summary 178
References 178
Chapter 7: Pharmacology of Pediatric Anesthesia 179
Developmental Pharmacology 179
Neurotoxicity 196
Intravenous Agents 197
Opioids 208
Inhaled Anesthetic Agents 223
Local Anesthetic Agents 235
Neuromuscular Blocking Agents 239
Commonly Administered Anesthetic Adjuncts 257
Summary 261
References 261
Part II: General Approach to Pediatric Anesthesia 263
Chapter 8: Psychological Aspects of Pediatric Anesthesia 264
Psychological Preparation for Anesthesia and Surgery 264
Behavioral Outcomes of Preoperative Anxiety in Children 273
Summary 276
References 276
Chapter 9: Preoperative Preparation 277
Preanesthetic visit 277
Physical examination 278
The child with physical or mental disabilities 284
Drug abuse in the child and adolescent 285
Preoperative pregnancy testing 288
Preoperative orders 288
Preanesthetic medications 289
Summary 292
References 292
Chapter 10: Title 293
Humidifiers 293
Anesthesia breathing systems 294
Anesthesia machines 297
Summary 321
References 321
Chapter 11: Monitoring 322
Monitoring 322
Anesthetic Techniques 337
General Monitoring Procedures 338
Summary 343
References 343
Chapter 12: Airway Management 344
Developmental anatomy 344
Developmental Physiology 351
Developmental Airway Physics 352
Airway Equipment 354
Clinical airway care 359
Care of the child with a difficult airway 360
Summary 364
References 364
Chapter 13: Induction, Maintenance, and Recovery 365
Induction of General Anesthesia 366
Maintenance of anesthesia 372
Emergence and Extubation 385
Postanesthetic recovery 387
Summary 394
References 394
Chapter 14: Blood Conservation 395
Hemoglobin structure and function in the neonate, infant, and child 395
Physiologic anemia and the anemia of prematurity 398
Perioperative strategies for blood conservation 399
Transfusion triggers 407
Transfusion of red blood cells 408
Transfusion of fresh frozen plasma 410
Transfusion of platelets 411
Transfusion-associated complications 411
Massive transfusion 413
Intraoperative blood recovery 416
Blood substitutes 416
Summary 417
References 417
Chapter 15: Pain Management 418
Pain Assessment 419
Neurophysiology of Pain 420
Pharmacologic Management of Pain: The Conundrum of \"off-Label\" Drug Use 424
Pharmacologic Management of Pain 424
Complications of Opioid Therapy 434
Analgesic Adjuvants 438
Regional Anesthesia And Analgesia 440
Chronic Pain 443
Palliative Care 449
Conclusion 451
References 451
Chapter 16: Regional Anesthesia 452
Local Anesthesia in Children 452
Introduction to Ultrasound 461
Central Neuraxial Blockade 463
Peripheral Nerve Blocks 476
Truncal Blocks 497
Blocks of the Face and Scalp 507
Intravenous Regional Anesthesia 508
Topical Anesthesia 509
Practical Considerations to Pediatric Regional Anesthesia 510
Summary 510
References 510
Part III: Clinical Management of Specialized Surgical Problems 511
Chapter 17: Neonatology for Anesthesiologists 512
Development of the fetus and the intrauterine environment 513
Labor and delivery and perinatal events 513
Gestational age 515
The premature infant 516
Review of systems and developmental physiology 517
Outcomes 546
Summary 553
References 553
Chapter 18 Anesthesia for General Surgery in the Neonate 554
Anesthetic Pharmacology in the Neonate 554
General Approach to Intraoperative Monitoring of the Neonate 558
Minimal-Access Surgery in the Neonate 561
Specific Neonatal Surgical Lesions 564
Summary 588
References 588
Chapter 19: Anesthesia for Fetal Surgery 589
Diseases 589
Physiology 595
Surgical Issues 599
Anesthetic Plan 600
Summary 604
References 604
Chapter 20: Anesthesia for Congenital Heart Surgery 605
Pathophysiology of Congenital Heart Disease 606
Specific Lesions 612
Cardiopulmonary Bypass in Infants and Children 637
Heart, Lung, and Heart-Lung Transplantation 654
Summary 673
References 673
Chapter 21: Congenital Cardiac Anesthesia:Non-Bypass Procedures 674
Cardiac Factors Influencing Outcome And Anesthetic Risk 675
Preoperative Assessment 681
Intraoperative Management 682
Postoperative Management 684
Outcomes Of Common Congenital Heart Defects 684
Anesthesia For Closed Cardiac Procedures 696
Anesthesia For Cardiac Catheterization 702
Current And Future Directions 712
Summary 712
Chapter 22: Anesthesia for Neurosurgery 713
Developmental Considerations 713
Effects of Drugs on Neurophysiology 718
Preoperative Evaluation and Preparation 723
General Principles of Intraoperative Management 725
Monitoring 729
Specific Pediatric Neurosurgical Conditions 732
Summary 744
References 744
Chapter 23: Anesthesia for General Abdominal, Thoracic, Urologic, and Bariatric Surgery 745
Video Endoscopy 745
General Abdominal Surgery 746
General Thoracic Surgery 763
Urologic Surgery 778
Bariatric Surgery 782
Summary 785
References 785
Chapter 24: Anesthesia for Pediatric Otorhinolaryngologic Surgery 786
Anesthesia For Otologic Procedures 786
Anesthesia For Rhinologic Procedures 789
Anesthesia For Pharyngeal And Laryngeal Procedures 791
Anesthesia For Endoscopy 813
Summary 820
References 820
Chapter 25: Anesthesia for Plastic Surgery 821
Craniofacial Surgery 821
Extremity Surgery 840
summary 841
Chapter 26: Anesthesia for Orthopedic Surgery 842
Scoliosis 844
Joint Disorders 857
Syndromes Of Disproportionate Short Stature: Dwarfism 860
Osteogenesis Imperfecta 862
Osteopetrosis 863
Cerebral Palsy 863
Ilizarov Method 865
Tourniquets 866
Clubfoot 867
Developmental Dysplasia Of The Hip 867
Slipped Capital Femoral Epiphysis 867
Fractures 868
Fat Embolism Syndrome 868
Summary 869
References 869
Transplantation Supplemental Material e69
A. Artificial Organs and Assist Devices e69
B. Management Protocol for Patients with Fulminant Hepatic Failure e71
C. Children's Hospital of Pittsburgh of UPMC Liver Transplantation Protocol e75
D. Xenotransplantation e78
References e88
Chapter 27: Anesthesia for Ophthalmic Surgery 870
Anatomy And Physiology 870
General Considerations In Caring For The Ophthalmologic Patient 873
General Anesthetic Considerations 878
Intraoperative And Postoperative Complications 880
Specific Pathology And Surgical And Anesthetic Management 882
Summary 888
References 888
Chapter 28: Anesthesia for Organ Transplantation 889
Determination Of Brain Death In Children 891
Donor Strategies 892
Living Related Organ Donor 900
Immunosuppression 902
Liver Transplantation 905
Multivisceral And Intestinal Transplantations 928
Kidney Transplantation 931
Islet Cell, Pancreas, And Kidney-Pancreas Transplantations 938
Hematopoietic Stem-Cell Transplantation 943
Hepatocyte Transplantation 946
Posttransplantation Side Effects 946
Summary 949
Chapter 29: Anesthesia for Conjoined Twins 950
Incidence 950
Historical Perspectives 951
Embryology 952
Classification, Nomenclature, And Terminology 952
Ethics 954
Perinatal Considerations 955
Medical And Surgical Management 956
Investigations 956
Planning Before Surgery 957
Anesthetic Care Of Conjoined Twins 958
Anesthesia For Non–Separation Procedures 963
Anesthesia For Separation 966
Conclusion 969
References 970
Chapter 30: Anesthesia for the Pediatric Trauma Patient 971
Epidemiology 972
Pediatric Trauma Systems 972
Trauma Scoring Systems 974
Primary and Secondary Surveys 977
Anesthetic Perioperative Management 983
Specific Injuries 988
Summary 1002
References 1002
Chapter 31: Anesthesia for Burn Injuries 1003
Epidemiology 1003
Burn-Wound Assessment 1003
Pathophysiology 1006
Pharmacologic Alterations 1013
Considerations For Initial Management 1016
Perioperative Considerations 1019
Considerations For Other Burn Injuries 1021
Rehabilitation And Reconstructive Procedures 1022
Summary 1022
Acknowledgments 1022
References 1022
Chapter 32: Anesthesia for Pediatric Dentistry 1023
Human Dentition 1023
Dental Pathophysiology 1027
Patient Spectrum 1030
Dentist’s Needs And Techniques 1030
Sedation And Anesthesia For Dental Procedures 1033
Postoperative Problems 1037
Summary 1040
References 1040
Chapter 33: Anesthesia and Sedation for Pediatric Procedures Outside the Operating Room 1041
Requirements For Extramural Locations 1041
Periprocedural Patient Care: Standards Of Practice And Quality Assurance 1043
Postanesthesia Care 1045
Resuscitation 1046
Specific Extramural Sites 1046
Safety Issues For Patients And Their Anesthesiologists 1054
Difficult-Airway Management In The Radiology Suite 1057
Blood-Loss Management Outside Of The Operating Room 1057
Summary 1057
References 1057
Chapter 34: Anesthesia for Same-Day Surgical Procedures 1058
Procedures And Patients Amenable To Outpatient Surgery And Anesthesia 1059
Contraindications For Outpatient Anesthesia 1059
Preoperative Evaluation And Planning 1060
Underlying Illnesses And Complicating Factors 1063
Preoperative Preparation Of The Child And Family 1066
Anesthetic Techniques 1067
Postoperative Analgesia 1072
Pacu, Recovery, And Discharge Issues 1074
Complications And Unanticipated Admission 1075
Facility Design And Patient Throughput 1075
Summary 1076
References 1076
Chapter 35: Anesthesia for Office-Based Pediatric Anesthesia 1077
Why Office-Based Surgery And Anesthesia? 1080
Safety And Outcome 1080
Legislation And Regulations 1084
Clinical Aspects 1086
Establishing An Office-Based Practice 1092
Summary 1095
References 1095
Chapter 36: Systemic Disorders 1098
Endocrine Disorders 1099
Respiratory Disorders 1112
Cardiovascular Disorders 1125
Hematology And Oncology Issues: Hereditary And Congenital Disorders 1130
Coagulation: Developmental Aspects, Disorders Of Coagulation, And Perioperative Management Of Hemostasis 1144
Treatment Of The Bleeding Patient 1160
Miscellaneous Problems 1165
Genetic Muscle Disorders 1174
Summary 1182
References 1182
Part IV: Associated Problems in Pediatric Anesthesia 1097
Chapter 37: Malignant Hyperthermia 1183
Muscle Physiology 1184
Clinical Presentation 1186
Masseter Spasm 1187
Treatment Of An Acute Episode Of Malignant Hyperthermia 1189
Prophylactic Management 1191
Anesthesia Techniques 1195
Disorders Associated With Malignant Hyperthermia 1196
Contracture Test 1198
Anesthesiologists’ Responsibility To Other Physicians 1198
Summary 1199
References 1199
Chapter 38: Cardiopulmonary Resuscitation 1200
Cardiac Arrest During Anesthesia 1201
Cardiopulmonary Resuscitation 1206
Drugs For Resuscitation 1219
Electrical Interventions In Cardiopulmonary Resuscitation 1229
Arrhythmias In Cardiopulmonary Resuscitation 1232
Anesthesia-Associated Considerations During Cardiopulmonary Resuscitation 1242
Extracorporeal Support As Adjunctive Therapy During Cardiopulmonary Resuscitation 1243
Teamwork During Intraoperative Cardiac Arrest 1245
Postresuscitation Care 1248
References 1249
Chapter 39: Critical Care Medicine 1250
Respiratory System 1251
Cardiovascular System 1258
Renal System 1263
Neurologic Systems 1266
Hematology And Immunology 1268
Prophylaxis 1269
Summary: The Role of The Intensivist 1271
References 1272
Chapter 40: Safety and Outcome in Pediatric Anesthesia 1273
Anesthesia-Related Mortality 1274
Anesthesia-Related Morbidity In Infants And Children 1276
Common Causes of Anesthesia-Related Mishaps 1288
Prevention of Anesthesia-Related Mishaps 1290
Summary 1293
References 1293
Chapter 41: History of Pediatric Anesthesia 1294
Phase I: Pediatric Anesthesia Before 1940 1294
Phase II: Emergence Of Pediatric Anesthesia, 1940 to 1960 1296
Phase III: Era of Nonflammable Anesthetics, 1960 to 1980 1301
Phase IV: Progress and Sophistication, 1980 to Present 1304
Summary 1308
References 1308
Chapter 42: Medicolegal and Ethical Aspects 1309
Informed Consent 1309
Medical Malpractice Litigation 1312
References 1314
Index 1315
Appendix A: Pediatric Drug Dosages A1
Appendix B: Growth Curves A6
Appendix C: Normal Pulmonary Function Values A14
Appendix D: Index of Syndromes and Their Pediatric Anesthetic Implications A22
References A36
Chapter Questions 1
Chapter 2: Behavioral Development 1
Chapter 3: Respiratory Physiology in Infants and Children 1
Chapter 4: Cardiovascular Physiology 1
Chapter 5: Regulation of Fluids and Electrolytes 1
Chapter 6: Thermoregulation: Physiology and Perioperative Disturbances 2
Chapter 7: Pharmacology of Pediatric Anesthesia 2
Chapter 9: Preoperative Preparation 2
Chapter 12: Airway Management 3
Chapter 13: Induction, Maintenance, and Recovery 3
Chapter 14: Blood Conservation 4
Chapter 15: Pain Management 4
Chapter 16: Regional Anesthesia 4
Chapter 17: Neonatology for Anesthesiologists 4
Chapter 18: Anesthesia for General Surgery in the Neonate 5
Chapter 19: Anesthesia for Fetal Surgery 5
Chapters 20: Anesthesia for Congenital Heart Surgery, and 21: Congenital Cardiac Anesthesia: Non-Bypass Procedures 5
Chapter 22: Anesthesia for Neurosurgery 6
Chapter 23: Anesthesia for General Abdominal, Thoracic, Urologic, and Bariatric Surgery 7
Chapter 24: Anesthesia for Pediatric Otorhinolaryngologic Surgery 7
Chapter 25: Anesthesia for Plastic Surgery 7
Chapter 26: Anesthesia for Orthopedic Surgery 7
Chapter 27: Anesthesia for Ophthalmic Surgery 8
Chapter 28: Anesthesia for Organ Transplantation 8
Chapter 30: Anesthesia for the Pediatric Trauma Patient 8
Chapter 31: Anesthesia for Burn Injuries 8
Chapter 32: Anesthesia for Pediatric Dentistry 8
Chapter 36: Systemic Disorders 9
Chapter 37: Malignant Hyperthermia 9
Chapter 38: Cardiopulmonary Resuscitation 9
Answer Key 11