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
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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