Abstract
Medication management and fluid resuscitation are the cornerstones of
providing safe procedural sedation for any patient, pediatric or adult. Due to the
immature organ systems, vastly different body sizes and compositions, unique
pathologies, and altered metabolic pathways, knowledge of adult pharmacology and
fluid management cannot be directly applied to the pediatric patient. This chapter
describes the principles of pediatric pharmacology and their applications in various
common healthy and diseased physiologic states. Drug administration, clinical effects,
common pitfalls, and metabolism and elimination for the most important perioperative
medications are discussed in detail. Knowledge of proper perioperative fluid
administration in the healthy pediatric patient, as well as fluid resuscitation in shock
states and common electrolyte disturbances common to pediatric patients, can easily be
lifesaving. The assessment and treatment of these pathologic states are described in
detail.
Keywords: Acetaminophen, Benzodiazepines, Circulating blood volumes, Context-sensitive half time, Dehydration in infants and children, Diuretics, Drug excretion, Drug metabolism, Fluid and electrolyte requirements in children, Fluid compartments, Genetic variations affecting pharmacokinetics, Intravenous anesthetics, Local anesthetics, Neuromuscular blocking drugs, Nitrous oxide, NSAIDs, Opioids, Parenteral fluids and electrolytes, Pharmacodynamics in children, Pharmacokinetics, Postoperative nausea and vomiting, Postoperative pulmonary edema, Sedatives, Shock states, Volatile anesthetics, Volume of distribution.