Anesthesia Considerations for Operative Laparoscopy in Pediatric and Adolescent Gynecological Surgery

The advent and improvement of laparoscopic surgical techniques have led to expanded surgical and diagnostic indications for this technology in the pediatric patient. The anesthetic management in these cases poses special challenges due to pneumoperitoneum and extreme patient positioning (Nezhat et al., Nezhat’s video-assisted and robotic-assisted laparoscopy and hysteroscopy. Cambridge University Press, New York, 2013; Tanaka et al., Nezhat’s video-assisted and robotic-assisted laparoscopy and hysteroscopy. Cambridge University Press, New York, 2013). This chapter takes a close look at anesthetic challenges of pediatric and adolescent patients scheduled for laparoscopic surgery. It also describes preoperative considerations for pediatric surgery patients, including patient screening and premedication. Specific intraoperative and postoperative issues, including perioperative complications, pain management, and postoperative nausea and vomiting, all which are important for providing quality care and efficient patient experience, are discussed. The knowledge of the patient’s health status, along with the multiple physiologic changes that can occur and specific potential complications, allows the anesthesiologist to provide safer anesthesia care. This chapter provides an evidence-based overview of particular strategies in anesthesia care that have been utilized to improve the experience for pediatric and adolescent patients and their families.