Clinical Pediatric Anesthesia

A Case-Based Handbook

Second Edition

Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina

Offers examples of a wide range of relevant clinical scenarios
Covers the field of pediatric anesthesiology with a point-of-care approach

Clinical Pediatric Anesthesia

A Case-Based Handbook

Second Edition

Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina

Description

This second edition of Clinical Pediatric Anesthesia: A Case-Based Handbook offers a comprehensive review of the options, advantanges, and disadvantages of different aspects of the perioperative management of the pediatric patient, as well as examples of a wide range of relevant clinical scenarios. Chapters are organized into 15 sections and cover the field of pediatric anesthesiology with a point-of-care approach. Written by a team of over 50 Pediatric Anesthesiologists at tertiary children's hospitals, this highly accessible text provides readers with multiple approaches to the anesthetic care of the pediatric patient. Each chapter includes an introduction to the topic, followed by learning objectives, clinical vignettes, and a discussion section styled in a question-and-answer format, concluding with a summary of the highest-yield and most salient information. Chapters also provide annotated references and suggestions for further reading to facilitate in-depth study of topic. The variety of cases presented, along with the contributors' expertise, render valuable real-life clinical situations that promote critical thinking and evaluation necessary for all pediatric anesthesiology consultants.

Clinical Pediatric Anesthesia

A Case-Based Handbook

Second Edition

Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina

PART 1: Challenges in Pre-operative Consultation and Preparation
1) Preoperative Anxiety Management
Thomas Shaw
2) Electrolyte Disturbance in Pyloric Stenosis
Imelda Tjia
3) Upper Respiratory Infection
Kenneth Wayman
4) Acute Fluid Resuscitation for Intussusception
Erin Williams
5) Asthmatic for Adenotonsillectomy
Erin Williams
6) Preoperative Fasting in the Pediatric Patient
Nancy Hagerman and Eric Wittkugel

PART 2: Challenges in Pediatric Pharmacology
7) Malignant Hyperthermia
Erin Williams
8) Anaphylaxis
Lori Aronson, Diane Gordon, and Matthew Sjoblom
9) Anesthesia for MRI
Trung Du and Mohamed Mahmoud
10) Egg and Soy Allergies and Propofol Use
Lisa Heyden

PART 3: Challenges in Airway Management
11) Obstructive Sleep Apnea
Laura Ryan and Paul Hopkins
12) Foreign Body in the Airway
Vidya Chidambaran, Senthilkumar Sadhasivam
13) Laryngospasm (FESS or Ear Tubes)
Kathleen Chen and Brent Schakett
14) Tonsillar Bleed
Titilopemi Aina and Sharon Redd
15) Difficult Airway
Paul Hopkins and Laura Ryan
16) Laryngeal Papillomatosis
Carlos Rodriguez

PART 4: Challenges in Patients with Pulmonary Disease
17) Intraoperative Wheezing
Erin Williams and Julie Schackman
18) Cystic Fibrosis
Brian Tinch
19) Pectus Excavatum Repair
Chris Glover and Wallis Muhly

PART 5: Challenges in Blood and Fluid Management
20) Massive Transfusion in a Child
Stefan Sabato and Rachel Chapman
21) Management of Acutely Burned Children
Robert McDougall
22) Liver Transplant
Rahul Baijal and Carlos Campos
23) Craniosynostosis Repair
Helena Karlberg
24) Kidney Transplant
Titilopemi Aina and Miguel Prada

PART 6: Challenges in Congenital Heart Disease
25) Management of Children with CHD for Non-Cardiac Surgery
Dean Andropoulos
26) Single Ventricle Physiology
Erin Gottlieb and David Vener
27) Tetralogy of Fallot
Premal Trivedi and Pablo Motta
28) Cardiac Catheterization
Emad Mossad
29) Pulmonary Hypertension
Erin Williams

PART 7: Challenges in Ophthalmology
30) Open Globe Repair
Michael Lin and Erin Williams

PART 8: Challenges in Neurosurgical Conditions and Neuromonitoring
31) Prone Positioning for Posterior Fossa Tumor Resection
Matthew James
32) Spinal Surgery
Chris Glover and Kim Nguyen

PART 9: Challenges in Patients with Hematologic and Oncologic Disorders
33) Sickle Cell Disease
Erin Williams and Ann Ng
34) Hemophilia (Orthopedic surgery)
Rebecca McIntyre
35) Leukemic for LP/BMA/Radiation Treatment
Ann Ng and Erin Williams
36) Opioid Tolerant Patient
Michael Zelisko
37) Mediastinal Mass Biopsy
Lisa Caplan
38) Neuroblastoma Resection
Stefan Sabato

PART 10: Challenges in Metabolic and Endocrinologic Conditions
39) Diabetic Patient
Mario Patino and Anna Varughese
40) Diabetes with Ketoacidosis During Appendicitis with Perforation
Rahul Baijal and Carlos Campos
41) Hypopituitarism
Lori Aronson, Diane Gordon, and Matthew Sjoblom
42) Mitochondrial Disorder for Muscle Biopsy
Mary A. Felberg
43) Obesity
Kim Nguyen and Chris Glover
44) Perioperative Management of Pheochromocytoma
Yang Liu
45) Thyroid mass resection
Kalyani Govindan

PART 11: Challenges in the Perinatal period
46) Exploratory Laparotomy for Necrotizing Enterocolitis
Olutoyin Olutoye and Karla Wyatt
47) Former Premature for Hernia Repair
Geoff Frawley
48) Tracheoesophageal Fistula Repair
Titilopemi Aina and Catherine Seipel
49) Omphalocele/Gastroschisis
Olutoyin Olutoye and Karla Wyatt
50) Congenital Diaphragmatic Hernia Repair
Catherine Seipel
51) Myelomeningocele Repair
Annie Boat, Jagroop Mavi, and Senthilkumar Sadhasivam
52) Fetal: Exit Procedure for Cervical Mass
Olutoyin Olutoye and Caitlin Sutton
PART 12: Challenges in Pediatric Regional Anesthesia and Pain
53) Caudal vs. Penile Block
Kenneth Goldschneider, Michele Hendrickson, and Cheryl Maenpaa
54) Neonatal Epidural
Kenneth Goldschneider and David Moore
55) Complex Regional Pain Syndrome for Ambulatory Surgery
Caro Monico
56) Perioperative Management of the Child Following an Extremity Amputation
Jamie Sinton

PART 13: Challenges in Pediatric Syndromes
57) Down Syndrome
Melanie Handley
58) Muscular Dystrophy (Gastrostomy Tube Placement)
Renee Kreeger and James Spaeth
59) Mucopolysaccharidoses
Titilopemi Aina and Catherine Seipel
60) Epidermolysis Bullosa
Kim Nguyen
61) Osteogenesis Imperfecta
Aimee Kakascik
62) Cerebral Palsy
Megha Kanjia

PART 14: Challenges in the Post-Anesthesia Care Unit
63) Awareness and Recall
Erin Williams and Andrew Davidson
64) Acute Pain Management
Nihar Patel
65) Emergence Agitation
Mehernoor Watcha and Arvind Chandrakantan
66) Stridor after Extubation
Cheryl Gore
67) Postoperative Nausea and Vomiting in Patients with Prolonged QTc
Mehernoor Watcha and Adam Adler
68) Disclosure after Complication in the Operating Room
David Young

PART 15: CHALLENGES IN ETHICS
69) Blood Loss in the Jehovah's Witness Patient
Michelle Dalton
70) Organ Donation after Cardiac Death
David Mann and Caitlin Sutton
71) Do-Not- Resuscitate Order in the Operating Room
David Mann and Caitlin Sutton

Clinical Pediatric Anesthesia

A Case-Based Handbook

Second Edition

Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina

Author Information

Erin S. Williams, MD, Assistant Professor, Department of Anesthesiology, Perioperative, and Pain Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas

Olutoyin A. Olutoye, MD, Professor, Department of Anesthesiology, Perioperative, and Pain Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas

Catherine P. Seipel, MD, Assistant Professor, Department of Anesthesiology, Perioperative, and Pain Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas

Titilopemi Aina, MD, Assistant Professor, Department of Anesthesiology, Perioperative, and Pain Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas

Contributors:

ADAM C. ADLER, MD
Assistant Professor
Department of Anesthesiology, Preoperative and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

DEAN B. ANDROPOULOS, MD, MHCM
Anesthesiologist-in-Chief
Texas Children's Hospital,
Department of Anesthesiology, Perioperative and Pain Medicine
Professor, Anesthesiology and Pediatrics
Vice Chair for Clinical Affairs, Department of Anesthesiology
Baylor College of Medicine
Houston, TX

LORI A. ARONSON, MD
Associate Professor
Clinical Anesthesia & Pediatrics
Director of Liver Transplant Anesthesia
Cincinnati Children's Hospital
Cincinnati, OH

RAHUL BAIJAL, MD
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

ANNE C. BOAT, MD
Staff Anesthesiologist
Associate Professor
Department of Anesthesia
Cincinnati Children's Hospital
Cincinnati, OH

CARLOS J. CAMPOS MD
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

LISA CAPLAN, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

ARVIND CHANDRAKANTAN, MD, MBA, FAAP
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

RACHEL CHAPMAN, MD
Consultant Anesthetist
The Royal Children's Hospital Melbourne
Melbourne, VIC
Australia

KATHLEEN CHEN, M.D., MS
Assistant Professor
Department of Anesthesiology, Peioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

VIDYA CHIDAMBARAN, MD
Associate Professor
Department of Anesthesia
Cincinnati Children's Hospital
Cincinnati, OH

MICHELLE DALTON, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

TRUNG DU, MD
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

MARY A. FELBERG, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

GEOFF FRAWLEY, BSc, MBBS, FANZCA
Consultant Anaesthetist
The Royal Children's Hospital Melbourne
Melbourne, VIC
Australia

CHRIS D GLOVER MD, MBA
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

KENNETH R. GOLDSCHNEIDER, MD, FAAP
Professor
Director, Pain Management Center
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

DIANE GORDON, MD
Assistant Professor
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

CHERYL GORE, MB, MBA, M Ed
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

ERIN A. GOTTLIEB, MD
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

KALYANI GOVINDAN, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

NANCY HAGERMAN, MD
Assistant Professor
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

MELANIE HANDLEY, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

MICHELE HENDRICKSON, MD
Anesthesiologist
Pain Management Center
Cincinnati Children's Hospital
Cincinnati, OH

LISA D. HEYDEN, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

PAUL HOPKINS, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

MATTHEW J. JAMES, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

AIMEE G. KAKASCIK, DO
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

MEGHA KANJIA, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

HELENA KARLBERG, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

MICHAEL J. KIBELBEK, MD
Associate Professor
Department of Anesthesia
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

MATTHIAS W. KÖNIG, MD
Anesthesiology Specialist
Chapel Hill, NC

RENEE KREEGER, MD
Associate Professor of Clinical Anesthesia and Pediatrics
Division of Cardiac Anesthesia
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

C. DEAN KURTH, MD
Anesthesiologist-in-Chief
Chair, Department of Anesthesiology and Critical Care Medicine
Children's Hospital of Philadelphia
Philadelphia, PA

ERICA P. LIN, MD
Assistant Professor
Department of Anesthesia
Cincinnati Children's Hospital Medical Center
Cincinnatio, OH

MICHAEL LIN, MD
Assistant Professor
Department of Anesthesia
University of Texas Health Sciences Center at Houston
Houston, TX

YANG LIU, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

ANDREAS W. LOEPKE, MD, PhD, FAAP
Associate Division Chief of Cardiac Anesthesia
Children's Hospital of Philadelphia
Philadelphia, PA

CHERYL MAENPAA, MD
Anesthesiologist
Children's Healthcare of Atlanta
Emory University Hospital
Atlanta, GA

MOHAMED A. MAHMOUD, MD
Staff Anesthesiologist
Associate Professor
Departmetn of Anesthesia
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

DAVID G. MANN, MD
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Texas Children's Hospital
Baylor College of Medicine
Houston, TX

DAVID MARTIN, MD
Anesthesiologist
Department of Anesthesiology and Pain Medicine
Nationwide Children's Hospital
Washington, DC

JAGROOP MAVI, MD
Staff Anesthesiologist
Associate Professor
Department of Anesthesia
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

JOHN J. McAULIFFE III, MD, MBA
Research Director
Staff Anesthesiologist
Director, Institute Pediatric Anesthesia
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

ROBERT McDOUGALL
Deptuty Director
Anaesthesia and Pain Management
Honorary Clinical Associate Professor
The University of Melbourne
The Royal Children's Hospital Melbourne
Melbourne, VIC, Australia

REBECCA McINTYRE, MBBS, FANZCA
Department of Anaesthesia and Pain Management
Royal Children's Hospital
Melbourne, VIC, Australia

CARO MONICO, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

DAVID L. MOORE, MD
Associate Professor
Clinical Anesthesia and Pediatrics
Cincinnati Children's Hospital Medical Center
University of Cincinnati, College of Medicine
Cincinnati, OH

EMAD B. MOSSAD, MD
Professor
Associate-in-Chief, Clinical Affairs
Division Chief, Cardiovascular Anesthesiology
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

PABLO MOTTA, MD
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

WALLIS T MUHLY MD
Assistant Professor
Department of Anesthesiology and Critical Care Medicine
Children's Hospital of Philadelphia
Philadelphia, PA

ANN NG, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

KIM-PHUONG NGUYEN, MD
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

NIHAR PATEL, M.D.
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

MARIO PATINO, MD
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

MIGUEL PRADA, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

SHARON REDD, MD
Assistant Professor of Anesthesia
Clinical Director, Day Surgical Unit
Senior Associate in Perioperative Anesthesia
Boston Children's Hospital
Harvard Medical School
Boston, MA

CARLOS L RODRIGUEZ, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

LAURA RYAN, MD,
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

STEFANO SABATO, MBBS (Hons), FANZCA
Department of Anesthesia and Pain Management
Royal Children's Hospital
Melbourne,VIC
Australia

SENTHILKUMAR SADHASIVAM, MD, MPH
Associate Professor, Clinical Anesthesia and Pediatrics
Director, Acute and Perioperative Pain Management
Cincinnati Children's Hospital Medical Center
University of Cincinnati, College of Medicine
Cincinnati, OH

NANCY B. SAMOL, MD
Assistant Professor, Clinical Anesthesia and Pediatrics
Cincinnati Children's Hospital Medical Center
University of Cincinnati, College of Medicine
Cincinnati, OH

JULIE SCHACKMAN, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

BRENT SCHAKETT, M.D.
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

THOMAS L. SHAW, MD
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

JAMIE W. SINTON, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

MATTHEW D. SJOBLOM, MD
Department of Anesthesia
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

JAMES P. SPAETH, MD
Director of Cardiac Anesthesia
Department of Anesthesia
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

CAITLIN B. SUTTON, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

BRIAN TINCH, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

IMELDA TJIA MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

PREMAL M. TRIVEDI, MD
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

BEN TURNER, MD, MBBS, FANZCA, FCICM
Department of Anesthesia and Pain Management
Royal Children's Hospital
Melbourne, VIC
Australia

ANNA M. VARUGHESE, MD, MPH
Anesthesia Divisional Chief
Department of Anesthesia
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

DAVID F. VENER, MD
Associate Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

MEHERNOOR WATCHA, MD
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

KENNETH WAYMAN, M.D.,
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

ERIC WITTKUGEL, MD
Associate Professor
Department of Aneshtesia
Cincinnati Children's Hospital Medical Center
Cincinnati, OH

JUNZHENG WU, MD, ScD
Department of Anesthesia
Cincinnati Children's Hospital Medical Center
UC Department of Anesthesiology
Cincinnati, OH

KARLA E. K. WYATT, MD, MS
Assistant Professor
Department of Anesthesiology, Perioperative and Pain Medicine
Baylor College of Medicine
Texas Children's Hospital
Houston, TX

David A. Young M.D., M.Ed., M.B.A.
Professor of Anesthesiology and Pediatrics
Co-Chair, Medical School Admissions Committee
Baylor College of Medicine
Committee Chair, Pediatric Anesthesiology Simulation, CHSE
Medical Director, Pediatric Advanced Life Support Program
Department of Anesthesiology, Perioperative, and Pain Medicine
Texas Children's Hospital
Houston, TX

Michael Blaine Zelisko, MD
Clinical Director of Anesthesia Texas Children's West Campus
Assistant Professor
Department of Anesthesiology, Perioperative, and Pain Medicine
Texas Children's Hospital
Baylor College of Medicine
Houston, TX

Clinical Pediatric Anesthesia

A Case-Based Handbook

Second Edition

Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina

Reviews and Awards

"I recommend Clinical Pediatric Anesthesia - A Case-Based Handbook, Second Edition for anesthesia trainees who are preparing for their board examinations and pediatric anesthesiologists ... It is also an excellent teaching tool for academic pediatric anesthesiologists to facilitate formal or informal discussions with trainees." -- N. Sun, Canadian Journal of Anesthesia