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Anesthesia for thoracic surgery in infants and children

Teresa M Murray-Torres1,2, Peter D Winch1,3, Aymen N Naguib1,3

  • 1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, Missouri, USA.

Saudi Journal of Anaesthesia
|November 12, 2021
PubMed

Insights

Anesthesiologists face challenges in pediatric thoracic surgery. This review covers preoperative assessment, one-lung ventilation (OLV), and anesthetic management for various noncardiac thoracic procedures in children.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Cardiopulmonary Physiology

Background:

  • Pediatric thoracic surgery presents unique anesthetic challenges due to developmental variations in cardiopulmonary systems.
  • Coexisting medical conditions and specific surgical procedures require tailored anesthetic approaches for pediatric patients.

Purpose of the Study:

  • To provide a comprehensive overview of the perioperative anesthetic management for pediatric patients undergoing noncardiac thoracic surgery.
  • To highlight key considerations for preoperative assessment, one-lung ventilation (OLV), and specific surgical interventions.

Main Methods:

  • This narrative review synthesizes current literature on anesthetic management in pediatric noncardiac thoracic surgery.
  • Key topics include developmental physiology, preoperative evaluation, OLV techniques, and anesthetic implications of common thoracic procedures.

Main Results:

  • Safe and effective anesthetic care necessitates a deep understanding of pediatric cardiopulmonary development and surgical specifics.
  • Management strategies for OLV and various procedures like bronchoscopy, mediastinoscopy, thoracotomy, and thoracoscopy are discussed.

Conclusions:

  • Optimizing anesthetic management for pediatric thoracic surgery requires careful preoperative assessment and tailored intraoperative strategies.
  • Addressing pediatric-specific disease processes is crucial for successful outcomes in neonates, infants, and children undergoing thoracic procedures.

Keywords:
One-lung ventilationpediatric anesthesiathoracic surgerythoracoscopythoracotomy

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