Update in pediatric anesthesiology
In this section of Current Opinion in Anesthesiology, several of the most relevant issues in Pediatric Anesthesiology are presented and explored. As the popular press and the media have exposed the literature that has emerged regarding the potential neurotoxic effects of general anesthesia, the message to parents of young children is confusing and frightening. Frequently serious concerns of parents are voiced during the preoperative interview with their anesthesiologist and it is important that the anesthesiologist is fully informed. ‘Will my child have long term consequences after receiving a general anesthetic?’ ‘Will my child have a learning disability as a result of anesthesia?’ ‘Should surgery be postponed until my child is older?’ These are typical questions. Drs Vutskits and Davidson (pp. 337–342) present the evidence and guide anesthesiologists through the facts in an attempt to provide clarity on this issue. Similarly, parents, patients, and surgeons have questions regarding the safety and timing of general anesthesia when surgery is indicated following traumatic injury complicated by concussion. There is no evidence or data to guide anesthesiologists; however, Dr Tasker (pp. 343–348) presents a discourse on what is known about the pathophysiology of concussion and traumatic brain injury and it relates to general anesthesia. He has provided the reader with a perspective on autonomic nervous system function and cerebrovascular effects of concussion, and relevant clinical issues that warrant further study.