[Current concepts in perioperative management of children : preface and comments]

Area of Science:

• Pediatric Anesthesiology
• Evidence-Based Medicine
• Patient-Oriented Care

Context:

• Pediatric anesthesia management has undergone rapid evolution, moving towards more evidence-based and patient-centered practices.
• There's a growing emphasis on "focused and individualized" pre-anesthesia evaluations over routine laboratory tests and X-rays.
• Techniques to reduce anesthesia induction stress in children, including preoperative preparation, sedative premedication, and parent-present induction, are increasingly utilized.

Purpose:

• To outline recent advancements and best practices in pediatric anesthesia management.
• To highlight the shift from routine screenings to individualized pre-anesthesia evaluations.
• To discuss current trends in airway management, fluid therapy, ventilation, and emergence from anesthesia in pediatric patients.

Summary:

• Individualized pre-anesthesia evaluations are preferred over routine tests. Approaches like preoperative preparation and parent-present induction aim to reduce anesthesia induction stress.
• Cuffed tracheal tubes and laryngeal mask airways are increasingly used, with indications considered individually. Perioperative fluid therapy recommendations are evolving due to concerns about hyponatremia and hyperglycemia.
• Lung-protective ventilatory strategies are recommended for immature lungs. Emergence agitation, often linked to sevoflurane, requires attention, and pediatric anesthesia rotations are crucial for resident training.

Impact:

• Promotes safer and less stressful anesthetic experiences for pediatric patients.
• Encourages the adoption of modern airway management and fluid therapy protocols.
• Highlights the importance of specialized training in pediatric anesthesia for improved patient care and outcomes.