Book contents
- Frontmatter
- Contents
- Preface
- PART ONE COEXISTING DISEASES
- PART TWO SURGICAL PROCEDURES
- Anterior Spinal Fusion to Cystic Hygroma (Lymphatic Malformation) Excision
- Dental Extractions & Rehabilitation to Kidney Transplant
- Lacrimal Duct Probing & Irrigation to Pyloromyotomy
- Radiotherapy to Wilms' Tumor Excision
- PART THREE REGIONAL ANESTHESIA
Lacrimal Duct Probing & Irrigation to Pyloromyotomy
from PART TWO - SURGICAL PROCEDURES
Published online by Cambridge University Press: 10 November 2010
- Frontmatter
- Contents
- Preface
- PART ONE COEXISTING DISEASES
- PART TWO SURGICAL PROCEDURES
- Anterior Spinal Fusion to Cystic Hygroma (Lymphatic Malformation) Excision
- Dental Extractions & Rehabilitation to Kidney Transplant
- Lacrimal Duct Probing & Irrigation to Pyloromyotomy
- Radiotherapy to Wilms' Tumor Excision
- PART THREE REGIONAL ANESTHESIA
Summary
CO-EXISTING DISEASES
▪ Usually none
PREOPERATIVE ASSESSMENT
▪ Studies: none
▪ Premed: weigh against brevity of procedure
▪ PO/PR midazolam 0.5 mg/kg
▪ Acetaminophen 10–20 mg/kg PO
▪ NPO: std
PROCEDURAL CONSIDERATIONS
▪ Supine
▪ Ophthalmologist probes & irrigates lacrimal duct to verify patency.
▪ Surgical stimulation mild
▪ IV recommended: see risks
▪ Monitors: std
▪ Risks: Oculocardiac reflex due to pressure on globe; results in bradycardia; laryngospasm
▪ Irrigation fluid may pass into pharynx via the nasal passages & cause laryngospasm if pt in light plane of anesthesia.
▪ May use nasal suction during irrigation to decrease fluid into larynx
ANESTHETIC PLAN
▪ Std inhalation or IV induction
▪ Use face mask or LMA.
▪ ETT only if dictated by clinical scenario
▪ Maintenance: inhalation agent in O2/N2O with spontaneous Vent
▪ Maintain adequate depth of anesthesia until irrigation completed.
▪ Suction pharynx if large amount of irrigation required.
▪ Awaken in OR.
PAIN MANAGEMENT
▪ Acetaminophen
PACU/POSTOPERATIVE CONSIDERATIONS
▪ Analgesia: continue acetaminophen and/or nonsteroidal
LAPAROSCOPY
CO-EXISTING DISEASES
▪ Any intra-abdominal process
PREOPERATIVE ASSESSMENT
▪ Std fasting & premed
▪ Labs: T&C for neonates/infants
PROCEDURAL CONSIDERATIONS
▪ Neonatal/infant viscera & blood vessels may be punctured with blind insufflation.
▪ CO2 absorption across peritoneal cavity with increased CO2 elimination
▪ Hypercarbia will stimulate SNS with tachycardia, hypertension & arrhythmias.
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- Type
- Chapter
- Information
- Pediatric Anesthesia Practice , pp. 130 - 175Publisher: Cambridge University PressPrint publication year: 2007