Murray-Torres Teresa M, Winch Peter D, Naguib Aymen N, Tobias Joseph D
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, Missouri, USA.
Department of Anesthesiology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA.
Saudi J Anaesth. 2021 Jul-Sep;15(3):283-299. doi: 10.4103/sja.SJA_350_20. Epub 2021 Jun 19.
The management of infants and children presenting for thoracic surgery poses a variety of challenges for anesthesiologists. A thorough understanding of the implications of developmental changes in cardiopulmonary anatomy and physiology, associated comorbid conditions, and the proposed surgical intervention is essential in order to provide safe and effective clinical care. This narrative review discusses the perioperative anesthetic management of pediatric patients undergoing noncardiac thoracic surgery, beginning with the preoperative assessment. The considerations for the implementation and management of one-lung ventilation (OLV) will be reviewed, and as will the anesthetic implications of different surgical procedures including bronchoscopy, mediastinoscopy, thoracotomy, and thoracoscopy. We will also discuss pediatric-specific disease processes presenting in neonates, infants, and children, with an emphasis on those with unique impact on anesthetic management.
对于麻醉医生而言，为接受胸外科手术的婴幼儿进行管理面临着诸多挑战。全面了解心肺解剖学和生理学发育变化的影响、相关合并症以及拟行的手术干预措施，对于提供安全有效的临床护理至关重要。本叙述性综述从术前评估开始，讨论接受非心脏胸外科手术的儿科患者的围手术期麻醉管理。将回顾单肺通气（OLV）实施和管理的注意事项，以及包括支气管镜检查、纵隔镜检查、开胸手术和胸腔镜检查在内的不同手术操作的麻醉影响。我们还将讨论新生儿、婴儿和儿童中出现的儿科特有的疾病过程，重点关注那些对麻醉管理有独特影响的疾病。
