title: Anesthesia and intraoperative neurophysiological monitoring in children.
abstract: OBJECTIVE
  Anesthesia for pediatric patients undergoing surgery where intraoperative neurophysiological monitoring (IONM) is performed is based on an understanding of the anesthetic influence on the neural pathways involved and the physiology that supplies nutrients to the neural systems. Anesthesia in pediatric patients may be different than in adults due to the specific anesthesia considerations in children, notably the propofol infusion syndrome (PRIS) and the need to monitor immature neural pathways. This review was done to determine if the anesthesia protocols used were different than those used in adults.
  
  
  METHODS
  After reviewing the implications of anesthetic action, a survey of pediatric anesthesia practitioners in 40 North American centers was conducted to determine the anesthesia protocols used in pediatric surgery with IONM and if these were specifically modified over concerns about PRIS.
  
  
  RESULTS
  Twenty-five centers responded with 35 different protocols used by practitioners. These protocols are similar to protocols used in adult patients. Although no centers specifically avoided propofol in all patients, several strategies were used to reduce the dosage, avoid its use in selected patients, or monitor for the onset of the syndrome.
  
  
  CONCLUSIONS
  Anesthesia for pediatric patients undergoing surgery where IONM is being performed is consistent with the practice and principles of anesthesia for adults. Although PRIS has not caused major alterations in most patients, concern has modified the practice of some anesthesiologists.
authors.affiliation: Department of Anesthesiology, University of Colorado at Denver and Health Sciences Center, MS 8202, Anschutz Office West (AO1), 12631 E 17th Avenue, PO Box 6511, Aurora, CO 80045, USA. Tod.Sloan@ucdenver.edu
authors.forename: Tod
authors.initials: T
authors.lastname: Sloan
mesh_terms: D000758:Anesthesia / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D002648:Child; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D009656:North America; D010372:Pediatrics / Q000379:methods*; D017410:Practice Guidelines as Topic; D015742:Propofol / Q000008:administration & dosage
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol