Thông tin chi tiết tài liệu

Quốc hội

Thủ tướng Chính phủ

Liên bộ

Danh sách các Bộ, Ngành

Click vào tìm kiếm

Danh sách các tỉnh & thành phố trực thuộc Trung ương

Chi tiết tài liệu

Perioperative Medicine in Pediatric Anesthesia

Tác giả: Astuto, Marinella; Ingelmo, Pablo M

Chủ đề:

Chủ đề: Medicine; Pediatric Anesthesia; Perioperative Medicine

Nhà xuất bản: Springer

Năm xuất bản: 2016

Loại tài liệu: Book

Mô tả vật lý: 473 p.

Định danh: 978-3-319-21960-8

Ngôn ngữ: en

Liên kết: Anesthesia, Intensive Care and Pain in Neonates and Children;

Đọc trực tuyến

The opening section is dedicated to patient care prior to surgery and includes preoperative assessment and preparation. Care in the intraoperative period is then described, including the appropriate care when performing surgery in different locations and in various specialties, such as orthopedic surgery, neurosurgery, thoracic surgery, and abdominal and urological surgery. The subsequent section addresses perioperative care in children with special conditions, such as difficult airway, metabolic or neuromuscular diseases, or cancer. The remainder of the book is devoted to a range of further important topics and postoperative care.

Cover
Anesthesia, Intensive Care and Pain in Neonates and Children
Title
Copyright
Foreword
Preface
Acknowledgments
Contents
Contributors
1: Perioperative Medicine
- 1.1 What Is Perioperative Medicine?
- 1.2 Patients, Surgery, and Complications
- 1.3 A Model of Perioperative Medicine: Learning from Enhanced Recovery After Surgery (ERAS) Programs
- 1.4 Areas of Perioperative Medicine
  - 1.4.1 Preoperative Phase
    - 1.4.1.1 Preoperative Risk Assessment and Optimization
    - 1.4.1.2 Pre-habilitation
  - 1.4.2 Intraoperative Phase
  - 1.4.3 Postoperative Phase
    - 1.4.3.1 Intensity of Postoperative Care
    - 1.4.3.2 Postoperative Pain Management
    - 1.4.3.3 Hemodynamic Management and Echocardiography
    - 1.4.3.4 Noncardiac Ultrasound
    - 1.4.3.5 Chronic Postsurgical Pain
- 1.5 Perioperative Medicine: A Natural Extension of Anesthesiology?
- References
Part I: Perioperative Care Before Surgery
2: Preoperative Evaluation in Pediatric Anesthesia
- 2.1 Introduction
- 2.2 Operating Risk Stratification
- 2.3 Timing and Organization of the Preoperative Evaluation
- 2.4 Medical History and Physical Examination
- 2.5 Preoperative Tests
- Conclusion
- 2.6 Appendix A
- References
3: Preoperative Preparation
- 3.1 Non-pharmacological Preparation
  - 3.1.1 Preoperative Anxiety
  - 3.1.2 Preparation for Surgery
  - 3.1.3 Parental Presence During Induction of Anesthesia (PPIA)
- 3.2 Pharmacological Preparation
  - 3.2.1 Oral Route
    - 3.2.1.1 Midazolam
    - 3.2.1.2 Ketamine
    - 3.2.1.3 α2-Agonists
  - 3.2.2 Nasal Route
    - 3.2.2.1 Midazolam
    - 3.2.2.2 Ketamine
    - 3.2.2.3 α2-Agonists
  - 3.2.3 Rectal Route
    - 3.2.3.1 Midazolam
    - 3.2.3.2 Ketamine
    - 3.2.3.3 α2-Agonists
- 3.3 Preoperative Fasting
- References
4: Preoperative Consideration in Common Pathological and Nonpathological Conditions
- 4.1 Upper Respiratory Infections: URI
- 4.2 Asthma and Bronchial Hyperresponsiveness
- 4.3 Bronchopulmonary Dysplasia (BPD)
- 4.4 Allergies
- 4.5 Heart Murmurs
- 4.6 Vaccination
- References
Part II: Perioperative Care During Surgery
5: Perioperative Care in Day Hospital Surgery
- 5.1 Introduction
- 5.2 Epidemiology
- 5.3 Organizational Aspects
- 5.4 Selection Criteria
  - 5.4.1 Patient
    - 5.4.1.1 ASA Physical Status
    - 5.4.1.2 Age
    - 5.4.1.3 Malignant Hyperthermia
    - 5.4.1.4 Sudden Infant Death Syndrome
    - 5.4.1.5 Sickle Cell Disease
    - 5.4.1.6 Incidental Heart Murmurs
    - 5.4.1.7 Upper Respiratory Infection (URI)
    - 5.4.1.8 Asthma
  - 5.4.2 Procedure
  - 5.4.3 Social Factor
- 5.5 Patient Preparation and Premedication
  - 5.5.1 Fasting
  - 5.5.2 Premedication
  - 5.5.3 Pharmacological Premedication
- 5.6 Anesthesia
  - 5.6.1 Drugs
  - 5.6.2 Locoregional Anesthesia
  - 5.6.3 Spinal Block
  - 5.6.4 Caudal Block
  - 5.6.5 Ilioinguinal/Iliohypogastric Nerve Block
  - 5.6.6 Paravertebral Block
  - 5.6.7 Lower and Upper Extremity Nerve Blocks
  - 5.6.10 Fluid Therapy
  - 5.6.11 Airway
  - 5.6.8 Penile Block
  - 5.6.9 Opioids as Adjuvants in Locoregional Anesthesia
  - 5.6.12 Temperature
- 5.7 Analgesia
  - 5.7.1 Locoregional Anesthesia
- 5.8 Postoperative Nausea and Vomiting
- 5.9 Discharge
- 5.10 Special Consideration for Tonsillectomy
- References
6: Perioperative Care in Remote Locations
- 6.1 Pre-procedural Assessment
- 6.2 Anesthesiological Management
- 6.3 Inhalation Techniques
- 6.4 Intravenous Techniques
- 6.5 Complementary Techniques
- 6.6 Discharge
- References
7: Perioperative Care in Paediatric Orthopaedic Surgery
- 7.1 Clinical Practice
  - 7.1.1 Preoperative Evaluation in Orthopaedic Surgery
  - 7.1.2 Ambulatory Orthopaedic Surgery in Children
  - 7.1.3 Preoperative Fasting and Premedication
  - 7.1.4 Procedural Sedation
  - 7.1.5 Intraoperative Positioning
  - 7.1.6 Intraoperative Warming
  - 7.1.7 Tourniquet
  - 7.1.8 Blood Management
    - 7.1.8.1 Preoperative Donation of Autologous Blood
    - 7.1.8.2 Intraoperative Blood Recovery and Reinfusion
    - 7.1.8.3 Antifibrinolytics
    - 7.1.8.4 Transfusion Trigger
  - 7.1.9 Postoperative Care
    - 7.1.9.1 Pain Treatment
    - 7.1.9.2 Compartment Syndrome
    - 7.1.9.3 Fat Embolism
    - 7.1.9.4 Thromboprophylaxis
- 7.2 Peripheral Paediatric Orthopaedic Surgery
  - 7.2.1 Upper Limb
  - 7.2.2 Lower Limb
- 7.3 Scoliosis Surgery
- References
8: Perioperative Care of the Pediatric Neurosurgical Patient
- 8.1 Neurophysiology of the Pediatric Brain
  - 8.1.1 Cerebral Blood Flow
  - 8.1.2 Brain Energy Metabolism
  - 8.1.3 Cerebral Oxygen Metabolism
  - 8.1.4 Arterial Carbon Dioxide/Oxygen Tension (PaCO2/PaO2)
  - 8.1.5 Blood Pressure and Cerebral Autoregulation
  - 8.1.6 Intracranial Pressure
  - 8.1.7 Brain and Inflammation
  - 8.1.8 Pediatric Electrophysiology
  - 8.1.9 Anesthesia and Neurotoxicity
- 8.2 Perioperative Management
  - 8.2.1 Preoperative Assessment
  - 8.2.2 Induction
  - 8.2.3 Monitoring
  - 8.2.4 Positioning
  - 8.2.5 Maintenance of General Anesthesia
  - 8.2.6 Fluid Management
  - 8.2.7 Body Temperature
  - 8.2.8 Venous Air Embolism (VAE)
  - 8.2.9 Postoperative Care
- 8.3 Main Postoperative Complications
  - 8.3.1 Hyponatremia
  - 8.3.2 Diabetes Insipidus
  - 8.3.3 Hyperglycemia
  - 8.3.4 Brain Edema
- 8.4 Perioperative Prophylaxis
- 8.5 Main Neurosurgical Conditions in Pediatric Patients
  - 8.5.1 Hydrocephalus and Shunt Procedures
  - 8.5.2 Brain Tumors
  - 8.5.3 Epilepsy Surgery
  - 8.5.4 Craniosynostosis Repair
  - 8.5.5 Congenital Spinal Lesions
  - 8.5.6 Vascular Malformations
  - 8.5.7 Neuro-Endoscopy and Anesthesia
- Conclusions
- References
9: Pain After Surgical Correction of Congenital Chest Wall Deformities
- 9.1 Pectus Excavatum
  - 9.1.1 Background
  - 9.1.2 Surgical Technique
  - 9.1.3 Analgesic Considerations
- 9.2 Pectus Carinatum
  - 9.2.1 Background
  - 9.2.2 Surgical Techniques
  - 9.2.3 Analgesic Considerations
- Conclusions
- References
10: General Approach to Abdominal and Pelvic Procedures
- 10.1 Common Preoperative Considerations
- 10.2 Intraoperative Management
- 10.3 Postoperative Management
- Conclusion
- References
Part III: Perioperative Care in Special Situations and Conditions
11: Perioperative Care of Children with a Difficult Airway
- 11.1 Introduction
- 11.2 The Paediatric Airway
  - 11.2.1 Anatomical Considerations
  - 11.2.2 Physiological Considerations
  - 11.2.3 Clinical Consequences of Airway Obstruction
- 11.3 Classification of the Paediatric Airway
  - 11.3.1 Normal (Unexpected Difficult)
  - 11.3.2 Impaired Normal (Suspected Difficult)
  - 11.3.3 Expected Difficult Airway
  - 11.3.4 Approach to the Paediatric Airway
- 11.4 Management of the Paediatric Airway
  - 11.4.1 Managing the Unexpected Difficult Airway
- 11.5 Managing the Suspected Difficult (Previously Normal) Airway
- 11.6 Managing the Expected Difficult Airway
- 11.7 Paediatric Airway Equipment
- 11.8 Summary
- References
12: Perioperative Care of Children with Neuromuscular Disease
- 12.1 Introduction
- 12.2 Life-Threatening Complications of Anesthesia in NMDS
  - 12.2.1 Respiratory Failure
  - 12.2.2 Cardiovascular Failure
  - 12.2.3 Malignant Hyperthermia (MH)
    - 12.2.3.1 Patients at Risk
    - 12.2.3.2 Prevention
    - 12.2.3.3 Management of Acute Crisis
  - 12.2.4 Rhabdomyolysis
    - 12.2.4.1 Patients at Risk
    - 12.2.4.2 Prevention
    - 12.2.4.3 Management of Acute Crisis
  - 12.2.5 Hyperkalemic Cardiac Arrest Secondary to Denervation
    - 12.2.5.1 Pathologies at Risk
    - 12.2.5.2 Prevention
    - 12.2.5.3 Management of Acute Crisis
- 12.3 Preoperative Assessment and Management
  - 12.3.1 Neurological Assessment
  - 12.3.2 Pulmonary Assessment
  - 12.3.3 Cardiac Assessment
  - 12.3.4 Other Issues
  - 12.3.5 Preoperative Considerations in Specific NMDs
    - 12.3.5.1 Myasthenia Gravis
    - 12.3.5.2 Mitochondrial Myopathies
- 12.4 Intraoperative Management
  - 12.4.1 Succinylcholine and Halogenated Agents
  - 12.4.2 Total Intravenous Anesthesia (TIVA)
  - 12.4.3 Nondepolarizing Neuromuscular Blocking Agents (NMB)
  - 12.4.4 Regional Anesthesia
  - 12.4.5 Anesthetic Considerations in Specific NMDs
    - 12.4.5.1 GuillainBarrè Syndrome (GBS)
    - 12.4.5.2 Myasthenia Gravis (MG)
    - 12.4.5.3 Dystrophinopathies
    - 12.4.5.4 Myotonic Dystrophy
    - 12.4.5.5 Mitochondrial Myopathies
    - 12.4.5.6 Glycogenosis Type II (GSDII)
- 12.5 Postoperative Management
  - 12.5.1 Pain Control
  - 12.5.2 Respiratory Management
- References
13: Perioperative Care of Children with a Metabolic Disease
- 13.1 Sources of Information
- 13.2 Synthesis of the Informations
- 13.3 Example 1: A Urea Cycle Defect
- 13.4 Example 2: A Glycogenosis
- 13.5 A Mitochondrial Cytopathy
- 13.6 Developing a “Metabolic Disease” Reflex
- Conclusion
- References
14: Perioperative Care of Children with OSA
- 14.1 Introduction
  - 14.1.1 Epidemiology
  - 14.1.2 Clinical Presentation
  - 14.1.3 Risk Factors for OSA
  - 14.1.4 Consequences of OSA
- 14.2 Diagnosis of OSA
  - 14.2.1 Physical Exam and Medical History
  - 14.2.2 Diagnostics Test
  - 14.2.3 Cardiorespiratory Studies
  - 14.2.4 Oximetry
  - 14.2.5 Other Studies
  - 14.2.6 Future Prospective
- 14.3 Anatomical and Physiological Basis of Respiratory Control
  - 14.3.1 Upper Airway Anatomy and Its Relationship with OSA
    - 14.3.1.1 Nasopharynx
    - 14.3.1.2 Mouth and Pharynx
    - 14.3.1.3 Larynx
  - 14.3.2 Neuronal Control of Breathing in Sleep and Airway Collapsibility
- 14.4 Special Considerations
  - 14.4.1 Infants and Premature Infants
  - 14.4.2 The Obese Child
  - 14.4.3 Syndromes
  - 14.4.4 Central Hypoventilation Syndromes
- 14.5 Medical Treatment of OSA
- 14.6 Surgical Treatments
- 14.7 Anesthesia Management of the Patient with OSA
  - 14.7.1 General Recommendations: The American Society of Anesthesiology Guidelines
  - 14.7.2 Anesthesia Management Options
- 14.8 Specific Guidelines for Anesthesia Management of the Children Undergoing Adenotonsillectomy
  - 14.8.1 Recommendations for Adenotonsillectomy: Italian National Program Guidelines, American Academy of Otolaryngology—Head and Neck Surgery Guidelines, and American Association of Pediatrics Guidelines
  - 14.8.2 Anesthesia Management Options for Children Undergoing Adenotonsillectomy
    - 14.8.2.1 Intraoperative Management
    - 14.8.2.2 Postoperative Management
- Conclusions
- References
15: Perioperative Care of Children with Trauma
- 15.1 Primary Survey
  - 15.1.1 Airway
  - 15.1.2 Breathing
    - 15.1.2.1 Tension Pneumothorax
  - 15.1.3 Circulation
  - 15.1.4 Disability
  - 15.1.5 Exposure
  - 15.1.6 Family
- 15.2 Preoperative Evaluation and Management
- 15.3 Intraoperative Management
- 15.4 Intraoperative Fluid Management
- 15.5 Damage Control Strategy (DCS)
- 15.6 Postoperative Period
- 15.7 Sedation and Analgesia
- 15.8 Pain Assessment
- 15.9 Conclusion
- References
16: Perioperative Care of Children with Cancer
- 16.1 Pediatric Cancer Stats
- 16.2 Immunomodulatory Effects
  - 16.2.1 Toxicity of Oncological Therapies
    - 16.2.1.1 Chemotherapy
      - Cardiotoxicity
      - Pulmonary Toxicity
      - Hepatorenal Toxicity
      - Neurotoxicity
      - Hematological Effects
      - Hormone and Enzyme Production
    - 16.2.1.2 Radiation Toxicity
  - 16.2.2 Anterior Mediastinal Mass (AMM)
  - 16.2.3 Airway Lesions
  - 16.2.4 Neoplasia/Cancer
    - 16.2.4.1 Cardiovascular Effects and Considerations
    - 16.2.4.2 Pulmonary Effects and Considerations
    - 16.2.4.3 Renal Effects and Considerations
    - 16.2.4.4 Hepatic Effects and Considerations
    - 16.2.4.5 GI Effects and Considerations
    - 16.2.4.6 CNS Effects and Considerations
    - 16.2.4.7 Endocrine Effects and Considerations
    - 16.2.4.8 Hematological Effects and Considerations
    - 16.2.4.9 Psychiatric Considerations
  - 16.2.5 Tumor Lysis syndrome (TLS)
  - 16.2.6 Retinoic Acid Syndrome
- 16.3 Preoperative Evaluation
- 16.4 Pediatric Cancer Pain
  - 16.4.1 Definition
  - 16.4.2 Pain Assessment
  - 16.4.3 Pain Treatment
  - 16.4.4 Pharmacological Treatment
    - 16.4.4.1 Acetaminophen
    - 16.4.4.2 Ibuprofen
    - 16.4.4.3 Morphine
    - 16.4.4.4 Fentanyl
    - 16.4.4.5 Hydromorphone
    - 16.4.4.6 Methadone
    - 16.4.4.7 Oxycodone
    - 16.4.4.8 Naloxone
  - 16.4.5 Adjuvant Therapy
  - 16.4.6 Nonpharmacological Pain Management
  - 16.4.7 Post-op Pain in Cancer Patient
- 16.5 Sedation Techniques
- 16.6 Conclusion
- References
17: Perioperative Care of Children with Cerebral Palsy and Behavioral Problems
- 17.1 Introduction
- 17.2 Preoperative Evaluation
  - 17.2.1 General Aspects
  - 17.2.2 Specific Problems
  - 17.2.3 Spasticity
  - 17.2.4 Epilepsy
- 17.3 Perioperative Management
  - 17.3.1 Positioning and Venous Access
  - 17.3.2 Airway Management
  - 17.3.3 Thermal Homeostasis
  - 17.3.4 Pharmacodynamics and Pharmacokinetics
  - 17.3.5 Uncooperative Behavior at Induction
  - 17.3.6 Postoperative Analgesia
- 17.4 Typical Interventions
  - 17.4.1 Orthopedic Surgery
  - 17.4.2 Fundoplication and Gastrostomy
- Conclusions
- References
18: Perioperative Care of Neonates with Airway Obstruction
- 18.1 Presentation
- 18.2 Symptoms and Signs
- 18.3 Pathologies of the Upper Airway (Above the Glottis Structures)
- 18.4 Supraglottic and Laryngeal Pathologies
- 18.5 Subglottic and Tracheal Pathologies
- 18.6 Anesthetic Management
  - 18.6.1 Emergency Airway Rescue
  - 18.6.2 Anesthesia for Diagnostic and Therapeutic Procedures
  - 18.6.3 Planning for Postoperative Period
- Bibliography
- Conclusion
Part IV: Important Techniques for Perioperative Care
19: Vascular Access in the Perioperative Period
- 19.1 Ultrasound Guidance
  - 19.1.1 Advantages of Ultrasound Guidance
  - 19.1.2 Limitations of Ultrasound Guidance
  - 19.1.3 Guidelines for Ultrasound Guidance During Vascular Access
  - 19.1.4 Ultrasound Equipment
  - 19.1.5 Puncture Techniques (Fig. 19.6)
  - 19.1.6 Learning Curve
  - 19.1.7 Sterile Setting and Ergonomics (Fig. 19.11)
- 19.2 Peripheral Venous Access
  - 19.2.1 Indications
  - 19.2.2 The Choice of the Vein
  - 19.2.3 Standard Procedure
  - 19.2.4 Complications
    - 19.2.4.1 Phlebitis
    - 19.2.4.2 Extravasation
    - 19.2.4.3 Injection of a Residual Anesthetic Medication
    - 19.2.4.4 Specific Complications
- 19.3 Central Venous Access
  - 19.3.1 Indications
  - 19.3.2 General Aspects
    - 19.3.2.1 Equipment and Technique of Insertion
    - 19.3.2.2 Complications Common to All Sites
      - Immediate Complications
      - Intermediary Complications
      - Late Complications
  - 19.3.3 Access to the Superior Vena Cava
    - 19.3.3.1 The Internal Jugular Vein
      - Anatomy and Sonoanatomy
      - Landmark Approaches
      - Ultrasound-Guided Approaches
    - 19.3.3.2 Periclavicular Approaches
      - Supraclavicular Access to the Brachiocephalic Vein
        
        Ultrasound-Guided Approach
      - Infraclavicular Access to the Subclavian Vein
        
        Landmark Approach
        
        Ultrasound-Guided Approach [26]
      - Transpectoral Access to the Axillary Vein
        
        Ultrasound-Guided Approaches
    - 19.3.3.3 Complications Associated with SVC Catheterization
  - 19.3.4 Access to the Inferior Vena Cava
    - 19.3.4.1 The Femoral Vein
      - Anatomy
      - Landmark Approach
      - Ultrasound-Guided Approach
    - 19.3.4.2 Complication Associated with IVC Catheterization
- 19.4 Peripherally Inserted Central Catheters
  - 19.4.1 Indications
  - 19.4.2 Catheter Placement
    - 19.4.2.1 Sedation
    - 19.4.2.2 Vein Selection
    - 19.4.2.3 Catheter Selection
    - 19.4.2.4 Insertion Technique (Fig. 19.38)
    - 19.4.2.5 Catheter Tip Positioning
  - 19.4.3 Fixation and Maintenance
  - 19.4.4 Complications
    - 19.4.4.1 Mechanical Problems
    - 19.4.4.2 Infection
    - 19.4.4.3 Thrombosis
- 19.5 Intraosseous Route
  - 19.5.1 Description
  - 19.5.2 Perioperative Indications
  - 19.5.3 Technique
  - 19.5.4 Contraindication
  - 19.5.5 Complications
- 19.6 Arterial Access
  - 19.6.1 Indications and Equipment
  - 19.6.2 The Radial Artery
  - 19.6.3 The Femoral Artery
  - 19.6.4 Other Arteries
  - 19.6.5 Complications
- 19.7 Umbilical Access
  - 19.7.1 The Umbilical Vein
  - 19.7.2 The Umbilical Artery
  - 19.7.3 Specific Complications
- References
20: US-Guided Nerve Targets
- 20.1 Ultrasound Equipment
- 20.2 Minimum Requirements for Regional Anesthesia Ultrasound Equipment
  - 20.2.1 Ultrasound Probe
  - 20.2.2 Identification of the Structures in Ultrasonography
  - 20.2.3 Needle Handling
- 20.3 Ultrasound-Guided Regional Anesthetic Techniques
  - 20.3.1 Upper Limb Blocks
    - 20.3.1.1 Interscalene Approach
    - 20.3.1.2 Supraclavicular Approach
    - 20.3.1.3 Infraclavicular Approach
    - 20.3.1.4 Axillary Approach
  - 20.3.2 Lower Limb Blocks
    - 20.3.2.1 Femoral Nerve Approach
    - 20.3.2.2 Sciatic Nerve Block
    - 20.3.2.3 Saphenous Nerve Block
  - 20.3.3 Truncal Blocks
    - 20.3.3.1 Ilioinguinal-Iliohypogastric Nerve Block
    - 20.3.3.2 Rectus Sheath Block
    - 20.3.3.3 Transversus Abdominis Plane Block
  - 20.3.4 Continuous Peripheral Nerve Blocks
- References
21: Noninvasive Hemodynamic and Respiratory Monitoring During the Perioperative Period
- 21.1 Introduction
- 21.2 Noninvasive Monitoring of Respiratory Function
  - 21.2.1 Pulse Oximetry
  - 21.2.2 End-Tidal Carbon Dioxide Monitoring
  - 21.2.3 Transcutaneous CO2 Monitoring
  - 21.2.4 Acoustic Impedance Monitoring
- 21.3 Noninvasive Monitoring of Hemodynamic Function
  - 21.3.1 Cardiac Output Monitoring
  - 21.3.2 Electrocardiogram Monitoring
  - 21.3.3 Near-Infrared Spectroscopy
  - 21.3.4 Blood Pressure Monitor
- Conclusions
- References
Part V: Early and Long Term Consequences of Anesthesia and Surgery
22: Negative Behaviour After Surgery
- 22.1 Emergence Delirium, Emergence Agitation and Postoperative Pain
- 22.2 Consequences of e-PONB
- 22.3 Risk Factors
  - 22.3.1 Age and Gender
  - 22.3.2 Parents and Culture
  - 22.3.3 Preoperative Anxiety
  - 22.3.4 Surgery
  - 22.3.5 Inhalation Anaesthesia
  - 22.3.6 Propofol
- 22.4 Tools to Recognize and Quantify e-PONB
- 22.5 Prevention and Treatment
  - 22.5.1 Non-pharmacologic Approach
  - 22.5.2 Pharmacologic Approach
    - 22.5.2.1 Midazolam
    - 22.5.2.2 Alpha2-Adrenergic Agonists
    - 22.5.2.3 Intravenous Anaesthesia with Propofol
    - 22.5.2.4 Pain Management
  - 22.5.3 When and How to Treat e-PONB?
- Conclusion
- References
23: Acute Pain Management and Prevention
- 23.1 Introduction
- 23.2 Assessment of Pain
- 23.3 Multimodal Analgesia
- 23.4 Control of Acute Pain
  - 23.4.1 Opioid Analgesics (Table 23.2)
    - 23.4.1.1 Morphine
    - 23.4.1.2 Fentanyl
    - 23.4.1.3 Sufentanil
    - 23.4.1.4 Remifentanil
    - 23.4.1.5 Oxycodone
    - 23.4.1.6 Hydromorphone
    - 23.4.1.7 Methadone
    - 23.4.1.8 Nalbuphine
    - 23.4.1.9 Tramadol
    - 23.4.1.10 PCA, NCA, and PARCA (Table 23.3)
  - 23.4.2 Non-opioid Analgesics (Table 23.4)
    - 23.4.2.1 Acetaminophen (Paracetamol)
    - 23.4.2.2 NSAIDs
    - 23.4.2.3 Dexamethasone
    - 23.4.2.4 Ketamine
    - 23.4.2.5 Clonidine/Dexmedetomidine
    - 23.4.2.6 Sucrose
    - 23.4.2.7 Gabapentinoids
    - 23.4.2.8 Lidocaine Infusion
  - 23.4.3 Regional Anaesthesia
  - 23.4.4 Non-pharmacological Management of Pain and Anxiety
- 23.5 Time to Procedures Specific Strategies?
- 23.6 Analgesia at Home
- Conclusions
- References
24: Long-Term Consequences of Anesthesia (and Surgery) on the Infant Brain
- 24.1 Introduction
- 24.2 Limitations of Animal or Preclinical Data
- 24.3 Normal Development of Human Brain
- 24.4 Human Studies
- 24.5 Relevant Human Outcome Measure
- 24.6 Migration
- 24.7 Sample Size Issue
- 24.8 Duration and Number of Exposures
- 24.10 Impact of Surgery
- 24.9 Age at Exposure
- 24.11 Gender Issue
- 24.12 Other Important Factors
- 24.13 Ongoing and Future Studies
- 24.14 Conclusion
- 24.15 Authors Comment
- References
25: Prevention of Chronic Postsurgical Pain
- 25.1 Background
- 25.2 Magnitude of the Problem
- 25.3 General Mechanisms and Clinical Presentation
- 25.4 Factors Associated with CPSP in Children
  - 25.4.1 Surgical Factors
  - 25.4.2 Psychosocial Factors
  - 25.4.3 Patient-Related Factors
- 25.5 Prevention Strategies
  - 25.5.1 Surgical Technique
  - 25.5.2 Pharmacological Therapy
  - 25.5.3 Regional Blocks
  - 25.5.4 Other Potential Strategies
  - 25.5.5 Summary of the Preventing Strategies
- 25.6 Concluding Remarks
- References
Index