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General and Thoraco-Abdominal Surgery

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Manual of Pediatric Anesthesia

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Abstract

Many surgeries in children are of minor severity (hernia, circumcision, orchidopexy), are performed as outpatients and generally associated with minimal risk. Perioperative pain management should include regional anesthesia, nonsteroidal anti-inflammatory agents and opioids based on the severity of the pain. Major general and thoraco-abdominal surgery has shifted to minimally invasive laparoscopic surgery, which presents serious challenges in neonates including impairment of ventilation and circulation after insufflation of carbon dioxide. Surgery involving the thorax including trachea-esophageal atresia, congenital diaphragmatic hernia repair, and those associated with anterior mediastinal masses requires understanding of the pathophysiology and close communication between anesthesia and surgery. Complex surgery such as resection of a pheochromocytoma or liver transplantation includes advanced preparation of the child, mobilizing support services (blood bank and ICU) and an organized anesthesia team. Brain death and organ donation are complex subjects that require specialized multidisciplinary approach.

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Authors and Affiliations

  1. Buffalo, NY, USA

    Jerrold Lerman

  2. Quincy, MA, USA

    Charles J. Coté

  3. Blaine, WA, USA

    David J. Steward

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Lerman, J., Coté, C.J., Steward, D.J. (2016). General and Thoraco-Abdominal Surgery. In: Manual of Pediatric Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-319-30684-1_13

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  • DOI: https://doi.org/10.1007/978-3-319-30684-1_13

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