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Perioperative Management in Pediatric Neurosurgery Noritsugu KUNIHIRO 1 1Department of Pediatric Neurosurgery, Osaka City General Hospital Keyword: 小児脳神経外科 , 周術期管理 , 周術期輸液 , 予防抗菌薬 , 抗てんかん薬 , pediatric neurosurgery , perioperative management , perioperative intravenous fluid therapy , prophylactic antibiotics , antiepileptic drugs pp.1132-1140
Published Date 2022/11/10
DOI https://doi.org/10.11477/mf.1436204680
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 Appropriate perioperative management can facilitate good outcomes in pediatric neurosurgical patients. This section discusses infusion therapy, prophylactic antibiotics, and antiepileptic drugs in the perioperative management of pediatric neurosurgical patients. Fluid requirements were calculated using the Holiday and Segar formula and the 4-2-1 rule for determining hourly infusion requirements based on metabolic rate and body weight. Recently, the risk of hyponatremia with the use of hypotonic solutions has been reported, and an isotonic electrolyte solution with 1-2.5% glucose is recommended for maintenance infusions in the perioperative period. Pediatric perioperative prophylactic antibiotics have been recommended as follows: application of cephazolin(30 mg/kg)with a redosing interval of 3 h intraoperatively and continuation for 48 h or less postoperatively. However, even for shunt surgery, there are currently no evidence-based protocols regarding specific antibiotic recommendations or the duration of prophylactic antibiotics. Early antiepileptic prophylaxis is recommended in cases of severe head trauma in children, especially infants. Available intravenous antiepileptic drugs should be used with an understanding of their indications, characteristics, and side effects.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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