Pediatric Neuroanesthesia — a Review of the Recent Literature

Abstract

Purpose of Review Pediatric neuroanesthesia is a growing and still challenging subspecialty. The purpose of this review is to summarize the available knowledge and highlight the most recent findings of the literature on non-traumatic pediatric neuroanesthesia care. Recent Findings Several human studies have confirmed the negative effects of early life anesthetic exposure. According to non-human studies, volatile anesthetics and opioids contribute to tumor progression. Tranexamic acid effectively reduces perioperative blood loss; it is used in several different doses without standard guidelines on optimal dosing. The widespread use of neuromonitoring has necessitated the development of anesthetic methods that do not affect neuromuscular transmission. Summary Pediatric anesthetic neurotoxicity, management of intraoperative bleeding, and the effect of anesthesia on tumor growth are among the most debated and researched topics in pediatric neuroanesthesia. The lack of evidence and clinical guidelines underlines the need for further large prospective studies in this subspecialty.

Awake craniotomy for supratentorial tumors or epileptogenic lesions in pediatric patients: a 16-year retrospective cohort study

“…[7][8][9] Despite these concerns, successfully tolerated awake craniotomies have been reported in pediatric patients as young as 8 years of age with success rates comparable to those of adult patients. 10,11 In the last 2 decades, attempts have been made to delineate eligibility criteria for pediatric patients, such as a minimum age. One review described eligible adult patients as having a high degree of cooperation and motivation, while ineligible patients have considerable anxiety, emotional instability, or inability to concentrate.…”