HANDBOOK of PEDIATRIC ANESTHESIA NOTICE Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required The authors and the publisher oft his work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication oft his work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. 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New York Manon Hache, MD Assistant Professor of Anesthesiology Division of Pediatric Anesthesia Department of Anesthesiology Director of Pediatric Trauma Anesthesia New York Presbyterian-Morgan Stan ley Children's Hospital Columbia University Medical Center New York. New York Lena S. Sun, MD Emanuel M. Papper Professor of Pediatric Anesthesiology Chief, Division of Pediatric Anesthesia Vice Chair, Department of Anesthesiology New York Presbyterian-Morgan Stan ley Children's Hospital Columbia University Medical Center New York, New York I I New York Chicago San Francisco Athens London Madrid Mexico City Milan New Delhi Singapore Sydney Toronto Copyright C> 2015 by McGraw-Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission oft he publisher. 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This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. The editors and authors of this Handbook would like to acknowledge all of our colleagues, patients, and our families for their support and encouragement who made this Handbook a reality. This page intentionally left blank CONTENTS Contributors ......................................................... xi Preface .............................................................x iii 1 Introduction (Robert Kazim) .................................... 1 Part 1: Airway Z Tonsillectomy and Adenoidectomy in a Patient With Obstructive Sleep Apnea (Gracie M. Almeida-Chen) ............ 17 3 Posttonsillectomy Bleeding (Neeta R. Saraiya) .................. 23 4 Bilateral Myringotomy and Tubes in a Patient With an Upper Respiratory Tract Infection (Neeta R. Saraiya) ................... 25 5 Cleft Lip and Palate Repair (Gracie M.Aimeida-Chen) ........... 27 6 Epiglottitis (Gracie M. Almeida-Chen) .......................... 31 7 Postoperative Stridor (Gracie M. Almeida-Chen) ................ 34 8 Subglottic Stenosis (Gracie M. Almeida-Chen) .................. 37 9 Cystic Hygroma {Susan Y. LeO •••••••••••••••••••••••••••••••••• 41 10 Aspirated Foreign Body (Neeta R. Saraiya) •••••••••••••••••••••• 44 11 Laryngeal Papillomatosis {Neeta R. Saraiya) •••••••••••••••••••• 46 1Z Difficult Airway Management (Philipp J. Houck) ................ 48 Part 2: Cardiovascular 13 cardiopulmonary Bypass (Riva R. Ko) .......................... 55 14 Ventricular Septum Defect Repair (PhilippJ. Houck) ............ 59 15 Tetralogy ofFallot (Anthony J. Clapcich) ....................... 61 16 Single Ventricle Physiology(Riva R. Ko) ........................ 65 17 Pulmonary Hypertension (Arthur J. Smerling) .................. 70 18 cardiac catheterization After Heart Transplantation (Philipp J. Houck) ............................. 73 Part 3: Respiratory 19 Asthma (Gracie M. Almeida-Chen) ............................. 77 20 Bronchopulmonary Dysplasia (Gracie M. Almeida-Chen) ••••••• 80 21 Croup (Gracie M. Almeida-Chen) •••••••••••••••••••••••••••••• 84 22 Aspiration Pneumonia {Manon Hache) ........................ 87 23 Pulmonary Sequestration (Leila M. Pang, Manon Hache) ........ 90 Part 4: Neonates 24 Necrotizing Enterocolitis (Neeta R. Saraiya) .................... 95 25 Pyloric Stenosis (Philipp J. Houck) ............................. 97 26 Congenital Diaphragmatic Hernia (Neeta R. Saraiya) ............ 99 27 Tracheoesophageal Fistula (Neeta R. Saraiya) ................. 10 1 28 Gastroschisis and Omphalocele (Neeta R. Saraiya) ............. 10 3 vii viii Contents 29 Duodenal Atresia (Neeta R. Saraiya) ........................... 105 30 Malrotation (Neeta R. Saraiya) ................................ 10 7 31 Meconium Ileus (Leila M. Pang) ............................... 10 9 32 Imperforate Anus (Leila M. Pang) ............................. 111 33 Myelomeningocele (Leila M. Pang) ........................... 114 34 Sacrococcygeal Tumor (Leila M. Pang) ........................ 116 Part 5: Neuro 35 Hydrocephalus (Leila M. Pang) ••••••••••••••••••••••••••••••• 121 36 Status Epilepticus (William S. Schechter) •••••••••••••••••••••• 124 37 Chiari Malformation (Riva R. Ko) , •••••••••••• , ••• , ••• , •••••••• 128 38 Muscular Dystrophy (Riva R. Ko) .............................. 132 39 Myotonic Dystrophy (Riva R. Ko) .............................. 136 40 Spinal Muscular Atrophy (WilliamS. Schechter) ............... 140 41 Selective Dorsal Rhizotomy (Riva R. Ko) ....................... 143 42 Myasthenia Gravis (Riva R. Ko) ................................ 146 43 Moyamoya Disease (Riva R. Ko) ............................... 150 44 Tethered Spinal Cord (E. Heidi Jerome) ........................ 153 Part 6: Hematology/Oncology 45 Wilms'Tumor (Teeda Pinyavat) ••••••••••••••••••••••••••••••• 157 46 Anterior Mediastinal Mass (Teeda Pinyavat) ••••••••••••••••••• 160 47 Osteosarcoma (Teeda Pinyavat) •••••••••••••••••••••••••••••• 163 48 Posttransplant Lymphoproliferative Disorder (Teeda Pinyavat) •••••••••••••••••••••••••••••••••••• 166 49 Sickle Cell Disease (Caleb lng) ................................ 169 50 Massive Transfusion (Manon Hache) .......................... 172 51 Methemoglobinemia (Teeda Pinyavat) ....................... 174 52 Heparin-Induced Thrombocytopenia (Caleb lng) .............. 177 Part 7: Gastrointestinal Diseases 53 Esophagogastroduodenoscopy (Philipp J. Houck) ............. 183 54 Control of Upper Gastrointestinal Bleeding (Manon Hache) ..................................... 185 55 Liver Biopsy (Manon Hache) .................................. 188 56 Liver Transplantation (PhilippJ. Houck) ....................... 190 57 Crohn's Disease (PhilippJ. Houck) ............................ 193 Part 8: Metabolic Diseases 58 Egg and Soy Allergy (Manon Hache) •••••••••••••••••••••••••• 197 59 Hyperkalemia (Radhika Dinavahi) ............................ 199 Contents ix 60 Morbid Obesity (Tatiana Kubacki) ............................ 201 61 Mitochondrial Diseases (Teed a Pinyavat) ..................... 204 62 Diabetes Mellitus (Manon Hach~) ............................ 207 Part 9: Musculoskeletal 63 Hip Osteotomy (Susumu Ohkawa) ............................ 213 64 Shoulder Arthroscopy (Susumu Ohkawa) ..................... 215 65 Clubfoot (Susumu Ohkawa) .................................. 218 66 Osteogenesis lmperfecta (Philipp J. Houck) ••••••••••••••••••• 222 67 Arthrogryposis (Susumu Ohkawa) •••••••••••••••••••••••••••• 224 Part 1 0: Syndromes 68 Down Syndrome (Tatiana Kubacki, Manon HaeM) ............ 229 69 DiGeorge Syndrome (Manon Hach~) ......................... 232 70 Pierre Robin Sequence (Gracie M. Almeida-Chen) ............. 234 71 Treacher Collins Syndrome (Gracie M. Almeida-Chen) ......... 237 72 Klippei-Feil Syndrome (Gracie M. AI meida-Chen) .............. 240 73 CHARGE Syndrome (PhilippJ. Houck) ......................... 243 74 Cornelia de Lange Syndrome (Radhika Dinavahi) •••••••••••••• 245 75 Epidermolysis Bullosa (Philipp J. Houck) •••••••••••••••••••••• 247 76 Kearns-Sayre Syndrome (Radhika Dinavahi) ••••••••••••••••••• 249 77 PHACE Syndrome (Teeda Pinyavat) ........................... 251 Part 11: Off-Site Anesthesia 78 MRI for Brain Tumor (Riva R. Ko) ............................... 257 79 CT Scan for Craniosynostosis (William S. Schechter) ........... 260 80 SPECT Scan (William S. Schechter) ........................... 263 81 Gamma Knife Radiosurgery (WilliamS. Schechter) ............ 267 Part 12: Adults With Congenital Diseases 82 Adult With Down Syndrome (Susan Y. Lei) ••••••••••••••••••••• 273 83 Cystic Fibrosis (Susan Y. Lei) .................................. 277 84 Fontan Physiology (Susan Y. Lei) •••••••••••••••••••••••••••• , • 281 85 Eisenmenger Syndrome (Susan Y. Lei) ......................... 284 86 Juvenile Idiopathic Arthritis (Susan Y. Lei) ..................... 287 Part 13: Pain 87 Pain Management After Scoliosis Repair (John M. Saroyan) .... 293 88 Postoperative Pain Management in Sickle Cell Disease for Laparoscopic Cholecystectomy (Mary E. Tresgallo) •••••••••••• 295 89 Intravenous Patient-Controlled Analgesia (Mary E. Tresgallo) ••••••••••••••••••••••••••••••••• 298