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Anesthesia for intracranial surgery in infants and children

McClain, Craig D.; Soriano, Sulpicio G.

Current Opinion in Anaesthesiology: October 2014 - Volume 27 - Issue 5 - p 465–469
doi: 10.1097/ACO.0000000000000112
NEUROANESTHESIA: Edited by Kristin Engelhard

Purpose of review: Age-related differences in the surgical lesions, anatomy and physiological responses to surgery and anesthesia underlie the clinically relevant differences between pediatric patients and their adult counterparts. Anesthesiologists need to be aware of the unique challenges in the anesthetic management of the pediatric neurosurgical patient.

Recent findings: Neurosurgeons with subspecialty training in pediatrics have driven advances in intracranial surgery in infants and children. Subspecialization in pediatric neurosurgery and critical care has resulted in more favorable outcomes. Innovations in tumor, epilepsy and endoscopic and cerebrovascular neurosurgery are constantly being adapted to the pediatric patient. The highly specialized nature of these and other pediatric neurosurgical procedures prompt calls for similarly trained anesthesiologists for management of these infants and children.

Summary: The aim of this review is to highlight the impact of these techniques on the intraoperative management of the pediatric neurosurgical patient. These issues are essential in minimizing perioperative morbidity and mortality.

Department of Anesthesiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA

Correspondence to Sulpicio G. Soriano, MD, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. Tel: +1 617 355 6457; e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.