USA Surgery Today

Each year, millions of children undergo surgical and medical procedures that require anesthesia or deep sedation. In many countries (including the United States), the majority of pediatric anesthetics are administered outside specialized pediatric hospitals, and many procedures are performed by surgeons who do not limit their practice to pediatric surgery. Improved understanding of pediatric pathophysiology and pharmacology, increased survival of premature infants at earlier stages of gestation, and new developments in noninvasive monitoring are allowing more critically ill children to survive to benefit from the advances in surgical technique. Safer anesthetic drugs, dramatic changes in the management of the pediatric airway, and greater numbers of anesthesiologists better trained to administer anesthesia to infants and children have greatly improved the safety for both healthy and critically ill pediatric patients undergoing surgery. An overview of principles of pediatric anesthesia would be incomplete without discussion-related areas, including pediatric acute and chronic pain management, and procedural sedation.