الفهرس 
ANATOMICAL AND PHYSIOLOGICAL CONSIDERATIONS IN PEDIATRIC THORACIC ANESTHESIAOnly 14 pages are availabe for public view
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Abstract
T
horacic surgery in the neonate or the child may be indicated because of a variety of reasons. Congenital anomalies, acquired diseases, or a tumoral process may justify an intervention. Several disease states and abnormalities that may or may not be present at birth are the result or a consequence of underlaying genetic disorder or immunodeficiency. Although they are slowly evolutive, they will sooner require the patient to undergo thoracic surgery. Because of diversity in pathologies, which is associated with the complexity of the structures involved within the chest, the anesthetic considerations and the clinical management will require a good understanding of the physiopathology engaged in these processes.
The anesthesiologist caring for infants and children undergoing thoracic surgery faces many challenges. An understanding of the primary underlying lesion as well as associated anomalies that may affect perioperative management is paramount. Preoperative and intraoperative communication with the surgeon is also essential. A working knowledge of respiratory physiology and anatomy in infants and children is required for the planning and execution of appropriate intraoperative care. Familiarity with a variety of techniques for single-lung ventilation suited to the child’s size will provide optimal surgical exposure while minimizing trauma to the lungs and airways.
Fundamental to anesthetic management for the majority of thoracic procedures are two techniques: lung isolation to facilitate surgical access within the thorax and management of one-lung anesthesia. Pediatric anatomy and physiology, Preanesthetic assessment for thoracic surgery, then outline intraoperative management principles common to most thoracic surgical procedures, then discuss specific anesthetic considerations in common and less-common surgical operations, and finish with a description of postoperative management issues in pediatric thoracic surgical patients.
Providing perioperative care to infants and children undergoing thoracic surgery present a great challenge to the anesthesiologist. Knowledge of the physiology of one lung ventilation to detect any untoward event early, perfusion during surgery, monitoring requirements, appropriate anesthesia techniques and methods of providing single lung ventilation safely and effectively. Methods of postoperative analgesia are also important in managing pediatric patients undergoing thoracic surgery.