ABA Pediatric Anesthesiology key terms

A developmental pause in breathing lasting 20 seconds or more, or shorter if accompanied by bradycardia or desaturation, occurring in infants born before 37 weeks and persisting past the postmenstrual age at which it typically resolves.

The sum of gestational age at birth plus chronologic age after birth, used to judge organ maturity and to time elective surgery and outpatient discharge in former premature infants.

The duration of pregnancy measured from the first day of the last menstrual period, usually confirmed by early ultrasound, and the reference point from which postmenstrual and corrected ages are calculated.

A methylxanthine given to premature infants to stimulate respiratory drive, reduce apneic episodes, and decrease the need for mechanical ventilation; it is also used to prevent postoperative apnea in at-risk ex-premature infants.

The volume of gas remaining in the lungs at the end of a normal passive expiration; in infants it is small relative to oxygen consumption and closes easily, causing rapid desaturation during apnea.

The lung volume at which small airways begin to close during expiration; in infants and young children it can exceed functional residual capacity, promoting atelectasis and shunting during anesthesia.

Collapse of lung tissue resulting in loss of aerated alveoli and intrapulmonary shunting; in children it develops quickly after induction because of a compliant chest wall, small functional residual capacity, and cephalad diaphragmatic displacement.

Airway pressure maintained at the end of exhalation during mechanical ventilation that keeps alveoli open, increases functional residual capacity, and reduces atelectasis and shunt in anesthetized children.

A supraglottic device that seals over the laryngeal inlet to provide a patent airway without intubation; it is useful for short procedures in children but does not protect against aspiration or permit high airway pressures.

Reflex closure of the vocal cords triggered by stimuli such as secretions, airway manipulation, or light anesthesia, producing partial or complete upper airway obstruction that may require positive pressure, deepening anesthesia, or succinylcholine.

A clinical situation in which a practitioner trained in airway management has difficulty with face-mask ventilation, supraglottic device placement, laryngoscopy, or tracheal intubation; children have distinct anatomic predictors and require a preformulated rescue plan.

Indirect visualization of the larynx using a camera-equipped blade displayed on a screen; it improves glottic view in children with limited mouth opening, reduced neck mobility, or abnormal airway anatomy.

An induction technique using preoxygenation and a rapidly acting neuromuscular blocker with minimal delay to intubation, intended to reduce the risk of pulmonary aspiration in children at risk of a full stomach.

A depolarizing neuromuscular blocker with the fastest onset of available paralytic agents; it is avoided in children with burns, denervation, or undiagnosed myopathy because of the risk of life-threatening hyperkalemia.

A nondepolarizing aminosteroid neuromuscular blocker often used for rapid sequence induction in children; its prolonged effect can be promptly reversed with sugammadex.

A modified gamma-cyclodextrin that encapsulates rocuronium and vecuronium to reverse neuromuscular blockade rapidly, including after a large intubating dose, without relying on acetylcholinesterase inhibition.

Assessment of motor response to electrical nerve stimulation, typically train-of-four at the adductor pollicis or facial nerve, used to titrate blockers and confirm adequate reversal before extubation in children.

A pharmacogenetic hypermetabolic crisis triggered by volatile anesthetics or succinylcholine, marked by rising temperature, masseter or generalized rigidity, hypercarbia, and acidosis, treated by stopping triggers and giving dantrolene.

The specific antidote for malignant hyperthermia; it inhibits calcium release from the sarcoplasmic reticulum and must be reconstituted and given intravenously in weight-based doses as soon as the crisis is recognized.

The alveolar concentration of an inhaled anesthetic at which 50 percent of subjects do not move in response to a standard surgical stimulus; it is highest in infants, lower in neonates, and reduced by opioids and other adjuvants.

A nonpungent volatile anesthetic widely used for inhalational induction in children because it permits mask induction without airway irritation; it can cause dose-dependent hypotension and, rarely, convulsant activity.

An inhaled anesthetic and analgesic with low potency and rapid uptake and elimination; it expands gas-filled spaces, so it is avoided in bowel obstruction, pneumothorax, and middle-ear or vitreoretinal surgery.

A state of inconsolable agitation, disorientation, and thrashing occurring early after general anesthesia, most common in preschool children after sevoflurane; it is distinct from pain and typically resolves spontaneously.

A family-centered practice in which a prepared caregiver accompanies the child during anesthetic induction to reduce anxiety; it requires structured screening, coaching, and a designated escort to be safe and effective.

Hypertrophy of the pyloric muscle causing projectile nonbilious vomiting in young infants, leading to hypochloremic hypokalemic metabolic alkalosis with paradoxical aciduria; surgery is delayed until fluid and electrolyte deficits are corrected.

An inflammatory bowel necrosis affecting premature and sick neonates that causes sepsis, abdominal distention, and perforation; anesthetic care emphasizes resuscitation, avoidance of nitrous oxide, and hemodynamic support.

A defect allowing abdominal organs into the thorax that causes pulmonary hypoplasia and persistent pulmonary hypertension; management avoids high inflation pressures and targets preductal oxygen saturation rather than normal blood gases.

Failure of the pulmonary vascular resistance to fall after birth, causing right-to-left shunting and hypoxemia; therapy includes oxygen, inhaled nitric oxide, and avoidance of acidosis, hypothermia, and excessive airway pressure.

A selective pulmonary vasodilator delivered by ventilator that reduces pulmonary vascular resistance in ventilated lung units, improving oxygenation in persistent pulmonary hypertension and right ventricular failure.

Cardiopulmonary bypass support used for reversible respiratory or cardiac failure in children when conventional therapy fails; it requires systemic anticoagulation and alters drug pharmacokinetics by increasing distribution volume.

A structured approach to the depressed newborn using warming, airway positioning, stimulation, positive pressure ventilation, and chest compressions, with oxygen titrated and volume or epinephrine reserved for inadequate response.

Respiratory distress in a newborn who inhaled meconium, producing airway obstruction, chemical pneumonitis, air leak, and pulmonary hypertension; routine intubation for suctioning is no longer recommended for vigorous infants.

A single-shot or catheter-based injection through the sacral hiatus into the caudal epidural space, widely used for pediatric lower abdominal, urologic, and lower limb analgesia; dose is limited by local anesthetic toxicity thresholds.

A peripheral nerve block of the lower abdominal wall used for inguinal hernia repair and orchiopexy, often performed with landmark or ultrasound guidance as an alternative or adjunct to caudal analgesia.

An interfascial plane block depositing local anesthetic between the internal oblique and transversus abdominis muscles to provide somatic analgesia for abdominal surgery, typically under ultrasound guidance in children.

A dose-related syndrome of neurologic excitation followed by seizures and cardiovascular depression after local anesthetic absorption or intravascular injection, treated with airway support and intravenous lipid emulsion.

A centrally acting analgesic and antipyretic used as a multimodal adjunct in children; dosing must account for hepatic metabolism and reduced clearance in neonates to avoid hepatotoxicity.

A strategy combining agents with different mechanisms, such as acetaminophen, nonsteroidal anti-inflammatory drugs, opioids, and regional blocks, to improve pain relief while reducing opioid dose and side effects.