Anesthetic Considerations in Pediatric Neurosurgery

Aisling Conran Introduction

Children undergoing neurosurgery present a special challenge for the pediatric anesthesiologist and a number of issues need to be considered at all times. These patients often have central nervous system pathology with attendant concerns regarding raised intracranial pressure (ICP). Infants may respond to stress with bradycardia, have poor metabolic control, and their large surface-to-mass ratio makes them susceptible to heat loss. Prematurity, with its comorbid problems, is a particular anesthetic concern. Positioning pediatric patitents must be performed carefully. Emotional and intellectual development of the child must be considered when planning the anesthetic, especially induction, and in the performance of the anesthetic. Parental concerns, anxieties and consents must be addressed.

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