EXPERT’S OPINION   Free access

Minerva Anestesiologica 2009 April;75(4):191-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

New trends in pediatric anesthesia

Pietrini D. ¹, Piastra M. ¹, Lamperti M. ², Ingelmo P. M. ³

¹ Department of Anesthesiology and Intensive Care, Catholic University Medical School, Rome, Italy; ² Department of Neuroanesthesiology, C. Besta National Neurological Institute, Milan, Italy; ³ Department of Perioperating Medicine and Intensive Therapy, San Gerardo Hospital, Monza, Milan, Italy

The authors illustrate some relevant emerging topics in pediatric anesthesia. Endotracheal cuffed tubes have entered into routine clinical practice in younger patients. Concerns about tracheal stenosis were overcome when manufactures began to produce a new class of high volume, low pressure endotracheal tubes. Ultrasound-guided central venous cannulation helped anesthesiologists and intensivists to more efficaciously and safely perform the invasive monitoring required by ever more invasive surgical procedures. The utility of ultrasonography in peripheral nervous blocking has also been demonstrated. Better knowledge of the pathophysiology of both hypovolemic shock and coagulation dysfunction helped made it possible to face and successfully perform even major surgical procedures and treat more dramatic trauma. The introduction of devices to monitor anesthesia depth helped clinicians to better understand the pharmacodynamic effects of anesthetics, resulting in the maintenance of a more stable level of narcosis and the reduction of the incidence of awareness.