in epiglottitis o Inspiratory stridor is a late feature and should alert the practitioner to
impending complete upper airway obstruction
All experts now recommend routine administration of this drug in the treatment of croup
The most important anesthetic consideration in postintubation laryngeal edema is its
Dysphonia or change in voice quality (or altered cry in infants) is often the first and most prominent symptom of
Laryngeal papillomatosis is one of the most common causes of
hoarseness and airway obstruction in children
rare congenital abnormalities in the separation between the posterior laryngotracheal wall and the adjacent esophagus
Laryngeal clefts are graded according to
- level of involvement, ranging from type I (interarytenoid defect superior to the true vocal folds) to type IV
What are the typical manifestations of laryngeal clefts
- Stridor, choking, and regurgitation
- should be considered in any child with a history of feeding problems in association with respiratory complaints
In management of Anesthesia for patients with Laryngeal Clefts what dictates the anesthetic technique?
The safety of the patient ultimately dictates the anesthetic technique
___________ remains the gold standard in the diagnosis of laryngeal clefts
- true enlargement of the tongue
Symptoms of Macroglossia are
- Drooling, speech impairment, failure to thrive and stridor, with airway obstruction being the most feared consequence
- The child's ability to swallow, breath, and speak may be impaired to varying degrees depending on the extent of macroglossia
- Taste sensation may also be affected and cause feeding aversions
In a pediatric patient with laryngeal cleft _____________ under general anesthesia is optimal for endoscopic examination because spontaneous movement of the vocal cords and surrounding structures is maintained
In a patient with macroglossia, management of anesthesia will entail
- Preparations for a difficult airway must be made for any child with macroglossia coming for surgery
- Induction of anesthesia may occur only after endotracheal intubation, because the tongue is both enlarged and relatively fixed in position
____________ is the most common cause of snoring in children.
While daytime sleepiness is frequently reported in adults with obstructive sleep apnea, children will present with?
nonspecific behavioral difficulties such as hyperactivity and learning disability
Adenotonsillar hypertrophy in association with obstructive sleep disorder is NOT a contraindication to administering preoperative anxiolytic medication. True/False?
In a patient with Adenotonsillar Hypertrophy, induction is ussually accomplished by?
Induction of general anesthesia is usually accomplished with inhalation of sevoflurane and oxygen with or without nitrous oxide
In anesthesia of a patient with Adenotonsillar Hypertrophy ____________ is often needed to counteract the effects of a reduced upper airway muscle tone.
Moderate continuous positive pressure
In anesthesia of a pediatric patient with Adenotonsillar hypertrophy the most preffered ett is ?
Cuffed endotracheal tubes may be preferable to uncuffed tubes to minimize the chance of aspiration of blood
- If intubation is required in a patient with upper Respiratory Tract Infection
- Trachea should be instrumented only under a deep plane of anesthesia
- A smaller than expected endotracheal tube should be considered, because children with active or recent URI have a higher incidence of postintubation laryngeal edema
- Dexamethasone may also be given prophylactically with URIs to reduce
- Vesicoureteral Reflex (VUR) is diagnosed based on evidence of contrast reflux and is graded into one of five levels of severity:
Grades I and II are considered mild, grade III moderate, and grades IV and V severe
- The most severe cases of VUR (grade V) rarely resolve
without surgical intervention ***
Developmental Dysplasia of the Hip
- During spica casting, infants are often elevated on a wood frame for cast application
Particular attention must be paid to securing any airway device and preventing
accidental fall from the wood frame
in thoracic insufficiency syndrome, Surgery should be postponed
if any acute respiratory illness is present, since most patients already have compromised respiratory functions
- Early assessment of postoperative neurologic function is important for patients who underwent VEPTR procedure due to what d/o?
Thoracic insufficiency Syndrome
patients with idopathic juvenile arthritis, what are some reasons for anesthetic concerns for difficult airway?
- C.Spine mobility - check ROM
- TMJ - limits mouth opening
- can be compounded by micrognathic mandible
- Systemic complications such as pleuritis and pericarditis that affect periop cardiopulmonary funtion
- can be compounded by micrognathic mandible
- What is the most common type of renal cancer in children as well as the most common pediatric abdominal malignancy ***
Wilms's tumor, or nephroblastoma,
with a Wilm's Tumor, the most common finding is
an abdominal mass that may or may not be painful
Wilm's tumor post op pain management recommendation