Preoperative Evaluation, Premedication, and Induction of Anesthesia

Elizabeth A. Ghazal, Marissa Vadi, Linda J. Mason, Charles J. Coté

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Adequate preparation of children for anesthesia allows optimization of medical conditions and leads to decreased morbidity. The medical history and laboratory testing obtained preoperatively aid the anesthesiologist in determining readiness for the planned surgery. Preparedness begins with adherence to a preoperative fasting schedule for elective surgery, selecting appropriate premedication, formulating an anesthetic plan and anticipating postoperative concerns. There are a variety of techniques for inducing general anesthesia. The technique used depends on a number of factors including the child's developmental age, understanding and ability to cooperate, previous experiences, the presence of a parent and the interaction of these factors with the child's underlying medical or surgical conditions. This chapter discusses special problems encountered in the pediatric population that require additional considerations from anesthesiologists. The preoperative period can be a stressful time for the fearful child and for those with autism spectrum disorders thus requiring the anesthesiologist to tailor the approach to meet the child's needs. Other challenges that pediatric patients present include respiratory system conditions such as obstructive sleep apnea syndrome, bronchopulmonary dysplasia, difficult airway, upper respiratory tract infections and apnea in former preterm infants. Additional conditions that are discussed include diabetes, seizure disorders, and sickle cell disease. Finally, the detection of a cardiac murmur, anemia or a fever before elective surgery will present a dilemma whether to proceed. The preoperative visit is an essential component of identifying the pediatric patient's needs and devising a plan that leads to a superior patient experience, a decrease in the number of cancellations and improved outcomes.

Original languageEnglish (US)
Title of host publicationA Practice of Anesthesia for Infants and Children
PublisherElsevier
Pages35-68.e11
ISBN (Electronic)9780323556187
ISBN (Print)9780323429740
DOIs
StatePublished - Feb 16 2018
Externally publishedYes

Fingerprint

Premedication
Anesthesia
Pediatrics
Preoperative Period
Heart Murmurs
Bronchopulmonary Dysplasia
Aptitude
Sickle Cell Anemia
Obstructive Sleep Apnea
Apnea
Premature Infants
Respiratory Tract Infections
Respiratory System
General Anesthesia
Anesthetics
Anemia
Epilepsy
Fasting
Appointments and Schedules
Fever

Keywords

  • Fasting
  • Obesity
  • Obstructive sleep apnea syndrome (OSAS)
  • Parental presence during induction
  • Postanesthesia apnea in former preterm infants
  • Premedication
  • Upper respiratory tract infection (URI)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ghazal, E. A., Vadi, M., Mason, L. J., & Coté, C. J. (2018). Preoperative Evaluation, Premedication, and Induction of Anesthesia. In A Practice of Anesthesia for Infants and Children (pp. 35-68.e11). Elsevier. https://doi.org/10.1016/B978-0-323-42974-0.00004-5

Preoperative Evaluation, Premedication, and Induction of Anesthesia. / Ghazal, Elizabeth A.; Vadi, Marissa; Mason, Linda J.; Coté, Charles J.

A Practice of Anesthesia for Infants and Children. Elsevier, 2018. p. 35-68.e11.

Research output: Chapter in Book/Report/Conference proceedingChapter

Ghazal, EA, Vadi, M, Mason, LJ & Coté, CJ 2018, Preoperative Evaluation, Premedication, and Induction of Anesthesia. in A Practice of Anesthesia for Infants and Children. Elsevier, pp. 35-68.e11. https://doi.org/10.1016/B978-0-323-42974-0.00004-5
Ghazal EA, Vadi M, Mason LJ, Coté CJ. Preoperative Evaluation, Premedication, and Induction of Anesthesia. In A Practice of Anesthesia for Infants and Children. Elsevier. 2018. p. 35-68.e11 https://doi.org/10.1016/B978-0-323-42974-0.00004-5
Ghazal, Elizabeth A. ; Vadi, Marissa ; Mason, Linda J. ; Coté, Charles J. / Preoperative Evaluation, Premedication, and Induction of Anesthesia. A Practice of Anesthesia for Infants and Children. Elsevier, 2018. pp. 35-68.e11
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