Pediatrics

Clinical Resources

Pediatric Posterior and Anterior Spinal Fusion

Introduction

Posterior Spinal Fusion

  • Patients are usually teenagers with scoliosis.
  • IV or inhalational induction
  • Small dose of muscle relaxant is appropriate to facilitate intubation
  • 2 large bore peripheral intravenous lines and arterial catheter

Fetal Surgery-Twin-Twin Transfusion Syndrome

    Fetal Surgery-Myelomeningocele Repair

    • General anesthesia and occasionally boluses of nitroglycerine generally required for uterine relaxation (alternative is neuraxial block with nitroglycerine infusion; rarely used)
    • Premed with bicitra

    Fetal Surgery Cases

    Lung Isolation in Infants Children

    • When lung isolation is required for infants, we often intentionally mainstem single lumen endotracheal tubes. In older infants and toddlers, bronchial blockers can be used.

    Cransiosysostosis

    • Premature fusion of one or more cranial sutures requires surgical treatment within the first 9-10 months of life.
    • Premedication: versed 0.5-1mg/kg in response to patient's need, clinical status, and parents' input.

    Congenital Diaphragmatic Hernia (CDH)

      Cleft Palate

      • Usually performed at ~1 year of age
      • Accompanied by ear tube placement
      • Premedication: versed 0.5-1mg/kg in response to patient's need, clinical status, and parents' input
      • Inhalational induction with nitrous oxide and sevoflurane

      Cleft Lip

      • Usually performed at 10-12 weeks
      • No premedication
      • Inhalational induction with nitrous oxide and sevoflurane
      • Peripheral IV after induction
      • +/- muscle relaxant or propofol to facilitate intubation of the trachea

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