Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Sedation outside operating room for children has increasing importance. Paediatric patients with end stage liver diseases are of great importance for various and frequent procedures including gastrointestinal endoscopy, magnetic resonance imaging, computerized tomography, brachytherapy, catheterisation and interventional radiology. Anaesthesia plan plays critical role for the success of these procedures. Patient safety, ventilation, hemodynamic responses, side effects of anesthetics on liver, periprocedural analgesia are the main topics of attention. Informed consent, silent environment are needed. Airway management tools may help because of edema and ascites pushing diaphragm upwards resulting in lung atelectasis. Nasal capnography enables monitoring spontaneous ventilation. Enlargement of extravascular extracellular fluid and dysproteinemia affects drug behaviours. Drug elimination half-time as well as context sensitive half-time have to be taken into account and designed individually. The pressure above vena cava inferior results in preload decrease, thus reduction in cardiac output. Pulse wave variation monitoring helps in estimating circulating fluid status. Tendency for bleeding can be anticipated with fresh frozen plasma. Patient-controlled analgesia may be a choice of favour but close monitoring is required for repeated IV analgesics. Children's Hospital of Eastern Ontario Pain Scale would be a good monitoring tool for pain.

Biography

Baris Cankaya graduated from Ankara University Medical Faculty in 2000. He has been working as Anaesthesiology Specialist at Marmara University Training Hospital. He has attended academic meetings, nationally and internationally. His academic interest includes microcirculation, fluid therapy, resuscitation, patient safety and perioperative analgesia. Some of his certificates are: EPLS provider Berlin 2015, NLS provider Athens 2015 and MECOR Level I October 2014. He attended international workshops like ECMO workshop 2015, Leicester and Airway workshop, ICISA 2014, and Tel Aviv. He also attended symposiums, namely: International intensive care symposium �°stanbul 2015, ESA Focus Meeting on Perioperative Medicine: The paediatric patient 2014 and other symposiums at national and international level.

Email: cankayabaris@hotmail.com