Anesthesia for Pediatric Patients with Common Comorbidities Part I

Children undergoing anesthesia have many considerations of disease processes that require careful attention to details and addressing specific needs. There are several comorbidities that are frequently encountered in a pediatric setting. A common scenario is a child with an upper respiratory tract infection presenting for elective surgery. We will discuss the criteria to be considered regarding when it is safe to proceed with elective surgery and when the risk is high. Asthma is common among children, and exacerbation can occur during an anesthetic. Anesthetic management of children with these respiratory illnesses is discussed. Children with Down syndrome frequently present for various cardiac and non-cardiac surgical interventions. Anesthetic issues relating to their non-cardiac surgeries will be discussed. Children with sickle cell disease is yet another group of patients frequently admitted to the hospital with sickle cell crisis. They warrant attention to specific details to ensure getting through surgery safely and require optimal pain management. Obstructive sleep apnea is increasingly encountered in children presenting for surgical procedures. Anesthetic challenges and risks they pose will be discussed. 

Keywords: Acute chest syndrome, Apnea-hypopnea index, Asthma, Bronchospasm, Central sleep apnea, Cervical spine instability, Deep extubation, Down syndrome, Hemoglobin F, Laryngeal mask airway, Laryngospasm, Obstructive sleep apnea, Perioperative respiratory adverse events, Red blood cell transfusion, Short-acting beta2 agonist, Sickle cell disease, Sleep-disordered breathing, Upper respiratory tract infection, Vaso-occlusive crisis, Wheezing.