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Record Nr. |
UNINA9910502980703321 |
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Autore |
Rath Girija Prasad |
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Titolo |
Fundamentals of pediatric neuroanesthesia / / Girija Prasad Rath |
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Pubbl/distr/stampa |
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Singapore : , : Springer, , [2021] |
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©2021 |
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ISBN |
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Descrizione fisica |
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1 online resource (710 pages) |
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Disciplina |
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Soggetti |
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Pediatric anesthesia |
Anestèsia en pediatria |
Llibres electrònics |
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Lingua di pubblicazione |
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Formato |
Materiale a stampa |
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Livello bibliografico |
Monografia |
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Nota di contenuto |
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Intro -- Foreword -- Preface -- Acknowledgments -- Contents -- About the Editor -- Part I: General Considerations -- 1: Pediatric Neuroanesthesia: Evolution of a New Subspeciality -- 1.1 Introduction -- 1.2 Development of Neuroanesthesia Along with Neurosurgery -- 1.3 Development of Pediatric Neurosurgery as a Subspecialty -- 1.3.1 Neurosurgery: An Indian Perspective -- 1.4 Pediatric Neuroanesthesia: Not Just "Anesthesia" or "Neuroanesthesia" -- 1.5 Future Prospects as a Subspeciality -- 1.6 Conclusion -- References -- 2: Developmental Anatomy and Physiology of the Central Nervous System in Children -- 2.1 Introduction -- 2.2 Development of the Central and Autonomic Nervous Systems -- 2.2.1 Intrauterine Development -- 2.2.2 Development of the Brain -- 2.2.3 Development of the Spinal Cord -- 2.2.4 Autonomic Nervous System (ANS) -- 2.2.5 Neuronal and Cellular Proliferation -- 2.2.6 Myelination -- 2.3 Relevant Anatomy -- 2.3.1 Head Size, Suture, and Fontanelle -- 2.4 Cerebral Vascular Anatomy -- 2.4.1 Arterial Circulation -- 2.4.2 Venous Drainage -- 2.5 Cerebral Physiology -- 2.5.1 Cerebral Blood Flow (CBF) -- 2.5.1.1 Factors Affecting Cerebral Blood Flow -- Cerebrovascular Reactivity to Carbon Dioxide in Children -- 2.5.2 Cerebral Metabolic Rate (CMR) -- 2.5.3 Cerebral Autoregulation (CA) -- 2.5.3.1 Cerebral Autoregulation (CA) in Neonates -- 2.5.3.2 |
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Cerebral Autoregulation (CA) in Small Children -- 2.5.4 Cerebral Spinal Fluid (CSF) Dynamics -- 2.5.5 Blood-Brain Barrier (BBB) -- 2.5.6 Intracranial Pressure (ICP) -- 2.5.7 Cerebral Compliance (Intracranial Pressure-Volume Relationship) -- 2.5.7.1 Intracranial Compliance -- 2.6 Spinal Cord Anatomy and Physiology -- 2.6.1 Spinal Cord Vascular Anatomy -- 2.7 Neurotoxicity in the Immature Human Brain -- 2.8 Epileptogenesis in the Developing Brain. |
2.9 Neuroprotection -- 2.9.1 General Measures -- 2.9.2 Anesthetic Agents -- 2.9.3 Temperature Control: Therapeutic Hypothermia -- 2.9.4 Hypoxic-Ischemic Preconditioning -- 2.9.5 Remote Ischemic Preconditioning -- 2.9.6 Erythropoietin (EPO) -- 2.9.7 Progesterone -- 2.9.8 Neurotrophic Factors -- 2.9.9 Stem Cell Treatment -- 2.10 Cerebral Physiology in Pathological States -- 2.11 Conclusion -- References -- 3: Effect of Sedatives and Anesthetics on Cerebral Physiology in Children -- 3.1 Introduction -- 3.2 Effect of Specific Anesthetic Agents -- 3.2.1 Inhaled Anesthetics -- 3.2.1.1 Nitrous Oxide -- 3.2.1.2 Halothane -- 3.2.1.3 Isoflurane -- 3.2.1.4 Sevoflurane -- 3.2.1.5 Desflurane -- 3.2.1.6 Xenon -- 3.2.2 Intravenous Anesthetics -- 3.2.2.1 Propofol -- 3.2.2.2 Thiopentone -- 3.2.2.3 Etomidate -- 3.2.2.4 Ketamine -- 3.2.3 Other Agents -- 3.2.3.1 Opioids -- 3.2.3.2 Benzodiazepines -- 3.2.3.3 Muscle Relaxants -- 3.2.3.4 Dexmedetomidine -- 3.3 Anesthetic Neuroprotection in Children -- 3.4 Conclusion -- References -- 4: Preoperative Evaluation and Preparation of Children Undergoing Neurosurgery -- 4.1 Introduction -- 4.2 History Taking in a Child Posted for Neurosurgery -- 4.3 Physical Examination -- 4.3.1 General Examination -- 4.4 Neurologic Examination -- 4.5 Airway Assessment -- 4.6 Cardiovascular Examination -- 4.7 Respiratory Examination -- 4.8 Other Systemic Examinations -- 4.9 Preoperative Investigations -- 4.10 Risk Stratification -- 4.11 Other Considerations -- 4.11.1 The Child with Physical or Mental Handicap -- 4.11.2 Drug Abusing Child and Adolescent -- 4.12 Preoperative Preparation -- 4.12.1 Preoperative Visit -- 4.12.2 Informed Consent -- 4.12.3 Fasting Guidelines -- 4.12.4 Premedication and Review of Current Medications -- 4.13 Conclusion -- References. |
5: Airway Equipment and Difficult Airway Management During Pediatric Neurosurgery -- 5.1 Introduction -- 5.2 Infant Versus Adult Airway -- 5.3 Predicting Difficult Airway in Children -- 5.4 Planning and Investigations -- 5.5 Conducting the Anesthetic -- 5.6 Equipment for Airway Management in Children -- 5.6.1 Pediatric Masks -- 5.6.2 Pediatric Laryngoscopes -- 5.6.3 Airway Adjuncts -- 5.6.4 Tracheal Tube Exchangers -- 5.6.5 Cuffed Endotracheal Tubes in Pediatric Patients -- 5.6.6 Reinforced Endotracheal Tubes in Pediatric Patients -- 5.6.7 Frova Intubating Introducer -- 5.6.8 Laryngeal Mask Airways (LMAs) and Other Supraglottic Airway Devices (SADs) -- 5.6.9 Video Laryngoscope -- 5.6.10 Fiberoptic Bronchoscope -- 5.6.11 Pediatric Anesthetic Circuit During Neurosurgery -- 5.7 Pediatric Neurosurgical Patients with Difficult Airway -- 5.7.1 Rapid Sequence Induction -- 5.7.2 Difficulty Securing the Airway -- 5.7.3 Difficulty in Maintaining the Airway -- 5.7.4 Difficult Extubation -- 5.8 The Pediatric Emergency Difficult Airway Cart -- 5.9 Escape Route for Cannot Intubate, Cannot Oxygenate (CICO) Scenarios -- 5.10 Pediatric Tracheostomy -- 5.11 Conclusion -- References -- 6: Anesthetizing Pediatric Neurosurgical Patients: A Practical Approach -- 6.1 Introduction -- 6.2 Preoperative Preparation -- 6.2.1 Preoperative Checks -- 6.2.1.1 Preoperative Assessment -- 6.2.1.2 Fasting and Consent -- 6.2.1.3 Radiology and Labs -- 6.2.1.4 Checklist -- 6.2.1.5 Anxiolysis on Day of Surgery -- 6.2.2 Operating Room |
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Preparation -- 6.3 Intraoperative Management -- 6.3.1 Vascular Access -- 6.3.2 Induction of Anesthesia -- 6.3.3 Intubation (Airway Management) -- 6.3.4 Maintenance of Anesthesia -- 6.3.5 Monitoring -- 6.3.5.1 Hemodynamic Monitoring -- 6.3.5.2 Neurophysiologic Monitoring -- 6.3.6 Positioning. |
6.3.7 Fluid and Blood Component Therapy -- 6.3.8 Glucose Homeostasis -- 6.3.9 Temperature Regulation -- 6.3.10 Intraoperative Complications -- 6.3.11 Emergence -- 6.4 Postoperative Care -- 6.4.1 PACU Considerations -- 6.4.1.1 Organization of PACU -- 6.4.1.2 Transport and Handover -- 6.4.2 Specific Entities in PACU -- 6.4.2.1 Emergence Delirium -- 6.4.2.2 Pain Management -- Opioids -- Non-opioids -- 6.4.2.3 Adverse Respiratory Events and Mechanical Ventilation -- 6.4.2.4 ICP Monitoring and Management -- 6.4.2.5 Fluid and Electrolyte Disturbances -- 6.5 Conclusion -- References -- 7: Positioning Children During Neurosurgery -- 7.1 Introduction -- 7.2 Historical Aspects -- 7.3 General Principles Common to all Pediatric Positions -- 7.3.1 Transport and Handling -- 7.3.2 Equipment -- 7.3.2.1 The Surgical Table -- 7.3.2.2 Accessories -- 7.3.2.3 Head Immobilization Devices -- 7.3.3 Protective Padding -- 7.3.4 Physiology of Patient Positioning -- 7.3.4.1 Respiratory Physiology -- 7.3.4.2 Circulation -- 7.3.4.3 Temperature Regulation -- 7.3.5 Head Position -- 7.3.6 Repositioning During Anesthesia -- 7.4 Basic Positions in Neurosurgery -- 7.4.1 Supine Position -- 7.4.2 Lateral Position -- 7.4.3 Park Bench Position -- 7.4.4 Prone Position -- 7.4.5 Head-Elevated Prone or Concorde Position -- 7.4.6 Sea Lion Prone or Sphinx Position -- 7.4.7 Sitting Position -- 7.5 Conclusion -- References -- 8: Monitoring Children Undergoing Neurosurgery -- 8.1 Introduction -- 8.2 Basic Monitoring -- 8.3 Special Monitoring -- 8.4 Monitoring the Nervous System -- 8.4.1 Monitoring Intracranial Pressure and Cerebral Blood Flow -- 8.4.1.1 Intracranial Pressure (ICP) -- Direct Methods -- Indirect Methods -- 8.4.2 Monitoring Metabolism and Oxygenation -- 8.4.2.1 Near-Infrared Spectroscopy -- 8.4.2.2 Brain Tissue Oxygen (PbtO2) Monitoring. |
8.4.2.3 Jugular Venous Oximetry -- 8.4.2.4 Cerebral Microdialysis -- 8.4.3 Transcranial Doppler (TCD) Ultrasonography -- 8.4.4 Monitoring of Function -- 8.4.4.1 Somatosensory Evoked Potentials (SSEPs) -- 8.4.4.2 Motor Evoked Potentials (MEPs) -- 8.4.4.3 Electromyography (EMG) -- 8.4.4.4 Visual Evoked Potentials (VEPs) -- 8.4.4.5 Brainstem Auditory Evoked Responses (BAERs) -- 8.4.4.6 Electroencephalography -- 8.5 Conclusion -- References -- 9: Perioperative Thermoregulation in Children and Temperature Monitoring -- 9.1 Introduction -- 9.2 Physiology of Thermoregulation -- 9.2.1 Thermoregulation in Newborn -- 9.3 Effects of Anesthesia on Thermoregulation -- 9.4 Perioperative Hypothermia -- 9.4.1 Adverse Effects of Hypothermia -- 9.5 Perioperative Thermal Manipulations -- 9.6 Temperature Monitoring -- 9.7 Perioperative Hyperthermia -- 9.8 Malignant Hyperthermia in Children -- 9.9 Targeted Temperature Management in Pediatric Neurointensive Care -- 9.10 Conclusion -- References -- 10: Fluid and Electrolytes Management in Children Undergoing Neurosurgery -- 10.1 Introduction -- 10.2 General Considerations -- 10.3 Choice of Fluid During Pediatric Neurosurgery -- 10.3.1 Fluid Considerations Before Surgery -- 10.3.2 Assessment and Correction of Fluid Deficit -- 10.3.3 Maintenance Fluid Requirements -- 10.3.4 Management of Other Losses During Surgery -- 10.3.5 Postoperative Fluid Management and Monitoring of Fluid Therapy -- 10.4 General Principles for Electrolytes Management -- 10.5 Sodium Disturbances -- 10.5.1 Hyponatremia -- 10.5.2 Hypernatremia -- 10.5.3 Diabetes |
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Insipidus (DI) -- 10.5.4 Hyperkalemia -- 10.5.5 Hypokalemia -- 10.5.6 Hypocalcemia -- 10.5.7 Hypercalcemia -- 10.5.8 Hypophosphatemia -- 10.5.9 Hyperphosphatemia -- 10.5.10 Hypomagnesemia -- 10.5.11 Hypermagnesemia -- 10.6 Conclusions -- References. |
11: Blood Loss and Transfusion in Children Undergoing Neurosurgery. |
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