RT Book, Section
A1 Amin, Sapan
A2 Ellinas, Herodotos
A2 Matthes, Kai
A2 Alrayashi, Walid
A2 Bilge, Aykut
SR Print(0)
ID 1176457032
T1 Hypnotics
T2 Clinical Pediatric Anesthesiology
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781259585746
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1176457032
RD 2024/09/13
AB FOCUS  POINTSBody  composition  is  different  in  children  than  in  adults,  with  children  having  a  higher  proportion  of  total  body  water  than  fat  and  muscle.Egg  allergy  does  not  preclude  propofol  use  (egg  lecithin)  because  the  usual  allergy  is  due  to  egg  albumin.Prolonged  propofol  infusions  (24  hours)  can  lead  to  propofol  infusion  syndrome  (PRIS),  which  is  a  syndrome  defined  by  metabolic  acidosis,  rhabdomyolysis,  lipemia,  and  hepatomegaly.Among  the  hypnotics,  only  ketamine  has  both  amnestic  and  analgesic  properties  and  is  considered  the  most  complete  anesthetic.Ketamine  should  be  used  with  caution  in  patients  that  are  sympathetically  depleted  (ICU  patients)  because  it  has  direct  myocardial  depressant  effects.Etomidate  provides  hemodynamic  stability  upon  administration  but  can  cause  adrenal  insufficiency  even  after  a  single  dose.Midazolam  is  the  most  common  premedication  in  adults  intravenously,  and  in  children  orally.Methohexital  can  be  used  for  maintenance  of  anesthesia  instead  of  propofol  in  patients  with  mitochondrial  disorders.  It  should  be  used  with  caution  in  patients  with  seizure  history.