General and Thoracoabdominal Surgery Including Management of Conjoined Twins

Abstract

Provision of safe anesthesia for the neonate undergoing thoracic or abdominal surgery presents several challenges for the pediatric anesthesiologist. This is a diverse group of patients, encompassing the robust term neonate presenting for elective inguinal hernia repair to morbidly sick extreme low-birth-weight neonates with necrotizing enterocolitis. This group presents with a huge variation in size, from approximately 500 g to 5 kg, and in the maturity of organ systems. Some will be cared for at home, whereas others will be cared for in the neonatal intensive care unit (NICU). Several surgical specialties may be involved in the care of the neonate including cardiothoracic, general surgery, hepatic surgery, and urology.