Overview

A Practice of Anesthesia for Infants and Children: Evidence-Based Perioperative Care, Developmental Pharmacology, Airway Management, and Cardiac and Regional Anesthesia Across Pediatric Surgical Specialties Pediatric anesthesia does not begin where adult anesthesia ends. The neonate, the infant, the toddler, and the adolescent each occupy a distinct point on a developmental continuum that demands its own physiologic understanding, its own pharmacological framework, and its own clinical approach. This textbook was written to address that continuum in full. A Practice of Anesthesia for Infants and Children by Dr. Stellan Briggs Holloway is a comprehensive, evidence-based clinical textbook written for anesthesiology residents preparing for pediatric rotations, fellows entering subspecialty training, practicing pediatric anesthesiologists seeking a current evidence synthesis, and certified registered nurse anesthetists managing pediatric cases across a range of clinical settings. The book is organized across ten sections covering the full scope of pediatric anesthesia practice from foundational developmental physiology through complex subspecialty surgery and critical perioperative events. The opening sections establish the physiologic and pharmacological foundation required before approaching any pediatric patient. Coverage includes growth and developmental physiology, preoperative evaluation and anesthetic induction, developmental pharmacokinetics and pharmacodynamics, drugs used in pediatric anesthesia with mechanisms and dosing, total intravenous anesthesia and target-controlled infusion, fluid management and transfusion medicine, pediatric airway anatomy and management, and pulmonary disease and perioperative respiratory care. Subsequent sections address organ system-specific anesthesia across cardiology and cardiac surgery, including anesthesia for pediatric cardiac surgery, cardiopulmonary bypass and mechanical circulatory support, and anesthesia for noncardiac surgery in children with congenital heart disease. Neurological and neurosurgical anesthesia is covered in full alongside a dedicated chapter on anesthetic neurotoxicity and neuroprotection in the developing brain. Endocrine, renal, hepatic, oncological, and abdominal surgical anesthesia are each addressed with a developmental perspective throughout. Surgical subspecialty chapters cover orthopedic and spine surgery, otolaryngologic and airway surgery, ophthalmologic and plastic surgery, burns and trauma, neonatal surgery and fetal intervention, and the premature infant. Emergency management chapters address cardiopulmonary resuscitation, malignant hyperthermia, and perioperative critical events. Regional anesthesia, acute pain management, chronic pain in children, procedural sedation outside the operating room, and anesthesia in non-operating room locations are each given dedicated chapter-length treatment. The book closes with postanesthesia care and enhanced recovery after surgery. Every chapter includes Clinical Pearl boxes containing practical insights, Evidence-Based Medicine boxes referencing landmark studies and current guidelines, and Treatment Algorithm boxes presenting stepwise decision frameworks for high-stakes clinical situations. Drug dosing throughout reflects current published guidelines and is presented as a clinical orientation reference. Back matter includes a glossary of pediatric anesthesia terms and four appendices covering pediatric drug dosing, normal vital signs by age, airway equipment sizing, and common anesthesia scoring systems. This textbook is designed to serve as both a foundational learning resource and a long-term clinical reference for every practitioner whose work places an infant or child in their care.

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