Orthopedic and Spine Surgery

ANESTHESIA FOR ORTHOPEDIC AND spinal surgery provides a multitude of challenges. Children often present with concomitant diseases that aff ect cardiovascular and respiratory function. Th e ability to maintain a clear airway during anesthesia is not straightforward in some of these children (e.g., those with arthrogryposis multiplex congenita).1 Operating times can be protracted. Signifi cant blood loss can occur and requires strategies for blood product management and transfusion reduction (see Chapter 10). Major trauma causing orthopedic injuries invariably involves other organ systems that may adversely interact with or compromise anesthetic management (see Chapter 39). Th e risks of aspiration of gastric contents into the lungs and the requisite fasting times, after even minor trauma involving an isolated forearm fracture, continue to be debated. Other Surgeries