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Perioperative Medicine in Pediatric Anesthesia

Ferrari, Lynne R. MD

doi: 10.1213/ANE.0000000000001512
Books, Multimedia, and Meeting Reviews

Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts,

T he specialty of anesthesiology has an expanded scope beyond the operating room. Anesthesiologists may be expected to share the responsibility for oversight of the entire multidisciplinary perioperative episode of care and the continuum of preoperative, intraoperative, and postoperative phases. The book Perioperative Medicine in Pediatric Anesthesia, edited by Marinella Astuto and Pablo M. Ingelmo, is a wonderful representation of the new perspective of the anesthesiologist as a perioperative physician. The well-informed anesthesiologist should be aware of emerging new technologies, standardized evidence-informed anesthesia protocols, minimally invasive surgical procedures, and enhanced postacute care processes, which play a role in improved clinical outcomes for pediatric surgical procedures. The authors have intended to provide a comprehensive overview of the current practices in pediatric perioperative care that encompass the expanded role of the anesthesiologist and provide practical answers and useful information for common questions. This publication focuses on the coordination and integration of care from the time that a child is scheduled for surgery or an interventional procedure until that child has returned to the care of the family and community.

Dr. Astuto from Italy and Dr. Ingelmo from Canada are two leaders in the field and have gathered an international panel of experts who have provided a comprehensive resource for anesthesiologists, pediatricians, and surgeons. The authors have provided an in-depth overview of current practices in pediatric perioperative care. They have attempted to translate research findings from well-designed studies to practical application in real clinical scenarios. Most textbooks focus on a single aspect of the perioperative care, but in this book, the entire spectrum of topics is presented in a very readable and easy to understand format. It should be considered “one stop shopping” for information on the perioperative management of pediatric surgical patients.

Each chapter is short and succinct but provides the essential information in handbook style. Within each chapter are headings that identify specific subjects with content below modeling an outline format making information easily retrievable. The book is divided into 5 sections. The “Care Before Surgery” section includes the essentials of preoperative preparation, preoptimization, and education of the family. This section explores both the behavioral and pharmacologic approaches during the preoperative phase. As the trend toward increased ambulatory procedures continues, the triage of patients and risk assessment is critical to the safe care of children. The section on “Care During Surgery” explores the inclusionary and exclusionary criteria for ambulatory versus inpatient status. This section also describes the considerations for various subspecialty surgical disciplines including the specific care of patients undergoing orthopedic, neurosurgical, abdominal, and pelvic procedures. The third section is a very complete review of the major intraoperative challenges including the difficult airway, neuromuscular and metabolic disease, obstructive sleep apnea, trauma, cerebral palsy, cancer, and behavioral problems. The final 2 sections are a testament to the uniqueness of this book. An entire section is dedicated to new techniques that are now part of the armamentarium of the perioperative anesthesiologist. Valuable sections on perioperative vascular access, ultrasound-guided regional anesthesia adjunct techniques, and noninvasive hemodynamic and respiratory monitoring, which are not usually included in references volumes on perioperative management, are included in this book. The final section addresses concerns around postoperative acute and chronic pain management, neurodevelopmental considerations, and behavioral issues.

An additional highlight of this book is the comprehensive index, which is very well organized and allows the reader to easily locate the subject of interest. Throughout the book, information is presented in a manner appropriate for both trainee and seasoned clinician. As anesthesiologists become increasingly responsible for the comprehensive care of patients, a book such as this is an important resource.

Lynne R. Ferrari, MDDepartment of AnaesthesiaHarvard Medical SchoolBoston, MassachusettsDepartment of AnesthesiologyPerioperative and Pain MedicineBoston Children’s HospitalBoston,

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