Abstract

CHILDREN ARE NOT SMALL ADULTS. In this chapter, we will discuss the resources and standards that must be in place, in order for community-based programs to be in a position to deliver quality anesthetic care to children. Patient and procedural selection policies, appropriate equipment, dedicated physical space, and knowledgeable and experienced providers are just some of what is required. Caring for children in a large children’s hospital, where the entire system is geared toward pediatrics, can test the most experienced pediatric anesthesiologist. Children have unique physiologic, pharmacologic, pathophysiology, and behavioral characteristics which change and develop throughout their lives. We will examine the pre-operative, intra-operative, and post-operative aspects that make pediatric anesthesia different from the perioperative care of adults. Additionally, we will provide an overview of the anesthetic management of some of the more common ambulatory pediatric procedures which may be encountered in the community-based practice such as; myringotomy and tympanostomy tube insertion; tonsillectomy and adenoidectomy; genitourinary procedures – circumcision, hypospadias repair, inguinal hernia repair, and orchiopexy; and foreign body removal.