Section 6 - Anesthesia for Pediatric ENT Surgery

Summary

Anesthesia for pediatric otorhinolaryngologic procedures represents the largest proportion of elective surgery for not only pediatric anesthesiologists but also general anesthesiologists taking care of children. Adenotonsillectomy (T&A) is one of the most commonly performed pediatric surgical procedures, with recurrent tonsillitis or pharyngitis and adenotonsillar hypertrophy as the major indications. Management and maintenance of anesthesia focuses on maintaining the patient's hemodynamic and volume status, guided by fluid therapy or blood transfusion. For urgent tracheotomies the anesthesiologist must determine whether the child can maintain an airway under general anesthesia and can be intubated by standard laryngoscopy or fiberoptic bronchoscopy. Otolaryngologic procedures require proper preoperative evaluation, intraoperative planning and anticipation of postoperative complications to ensure a favorable outcome. Laryngeal surgery can result in postoperative airway compromise, secondary to swelling or laryngo-tracheomalacia. A safe and smooth postoperative recovery can be achieved by anticipation of potential complications and careful planning for prophylaxis, and effective therapy.