ANESTHESIA FOR PEDIATRIC UROLOGICAL SURGERY

Anesthesia for pediatric urological surgery comprises a wide spectrum of clinical involvement, ranging from short periods of monitored care or sedation for brief outpatient procedures such as urethral meatotomy or urodynamic studies, to formidable cases such as repair of bladder exstrophy or resection of a Wilms' tumor, which requires general anesthesia with additional invasive monitoring and which may be associated with significant blood loss, fluid shifts, heat loss, or derangements in other organ systems. The anesthesiologist must be familiar with specific considerations for each of the commonly encountered urological lesions, including the feasibility of applying regional techniques for intraoperative anesthesia as well as for postoperative analgesia, the assessment of preexisting renal function, the implications of patient positioning, and the psychological aspects of genitourinary surgery for the pediatric patient.