TY - CHAP M1 - Book, Section TI - Pediatric Ambulatory Anesthesia: What is New and Safe? A1 - Butz, Steven A2 - Ellinas, Herodotos A2 - Matthes, Kai A2 - Alrayashi, Walid A2 - Bilge, Aykut PY - 2021 T2 - Clinical Pediatric Anesthesiology AB - FOCUS POINTSChildren with asthma are common in ambulatory surgery. Evaluation should be made for active disease. Rescheduling after a respiratory illness should be in 4 to 6 weeks.Prematurity is less common in ambulatory practices, but still can be a significant risk. Histories for young children should be investigated and cases delayed to 45 weeks post-conceptual age (PCA) for full-term babies and ranges from 51 to 60 weeks for premature infants. Later is safer.Congenital cardiac disease patients may be appropriate for outpatient surgery, but single-ventricle physiology should be absolutely avoided.Embryology may be considered in evaluating children with syndromes. Those associated with abnormal airway physiology may be especially difficult in the outpatient setting.Malignant hyperthermia (MH) is a genetic issue that may be unknown in pediatric patients prior to their exposure to an anesthetic. Neuromuscular syndromes may cause other anesthetic problems, but few are truly related to MH.Risk factors for adverse events in pediatric anesthesia are mostly related to younger age, but also coexisting diseases and less so to types of procedure, length of procedure, and lateness in the day of procedure.As with adults, children should be screened for sleep apnea especially in cases that involve the airway or long-term narcotic pain treatment. The STBUR score is analogous to STOP-BANG in adults.Emergence delirium is more common in pediatric patients. Absolute cause is uncertain, but a multi-prong approach may be used by identifying risk factors and planning medications used.Postoperative nausea and vomiting risk factors are different from adults and may be assessed case by case for age, procedure, family history, and surgery duration. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1176459742 ER -