By Lewis Spitz, Arnold Coran
The 6th version of this acclaimed operative atlas maintains to supply a different point of accomplished element at the complete variety of stipulations awarded in early life, together with the fetus and neonate, that may be handled by way of surgical capacity. All chapters were completely revised and up-to-date all through with new line diagrams the place useful. additionally touching upon symptoms, problems and non-operative administration, Operative Pedaitric Surgery continues to be the pre-eminent operative consultant to a whole variety of paediatric stipulations.
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The 6th variation of this acclaimed operative atlas keeps to supply a special point of finished element at the complete diversity of stipulations offered in early life, together with the fetus and neonate, that may be handled through surgical capacity. All chapters were completely revised and up to date all through with new line diagrams the place useful.
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Extra info for Operative Pediatric Surgery
The distended stomach carries the risk of aspiration and pneumonia, and may impair diaphragmatic excursion, resulting in respiratory distress. With congenital diaphragmatic hernia, ventilation is progressively impaired as the herniated intestine becomes distended with air and ﬂuid. With gastroschisis, omphalocele and diaphragmatic hernia, the ability to reduce the prolapsed intestine into the abdominal cavity is impaired by intestinal distension. This may be alleviated by adequate orogastric or nasogastric decompression.
In addition to TBW, extracellular water (ECW) also declines until 1–3 years of age. In the term infant, ECW is often 40 percent of birth weight at 5 days. By 3 months of age, this value decreases to 33 percent, stabilizing at adult values of 20–25 percent by 1 to 3 years of age. Conversely, fetal intracellular water (ICW) slowly increases during gestation and the neonatal period. At 20 weeks’ gestation, ICW is around 25 percent. This increases to 33 percent at the time of birth, ﬁnally reaching adult levels of around 44 percent by 3 months of age.
PREMEDICATION There is no ideal agent for premedication. The aim is to achieve mild sedation for most children, since a dose required to produce sleep in most, will cause over-sedation in a few. In recent years, preoperative medication has become less important, with parents always being present at induction and the universal use of topical anesthetic creams to allow painless intravenous induction of anesthesia. Opioid premedication is rarely used, as intramuscular injections are so disliked, and intraoperative and postoperative analgesia is usually managed by speciﬁc measures involving regional analgesia or intravenous opioid infusions.
Operative Pediatric Surgery by Lewis Spitz, Arnold Coran