Anaesthesia for thoracic surgery in children poses a variety of challenges for the paediatric anaesthetist, who will encounter problems different from those faced in adult practice. It is a low-volume surgical speciality, thus predominantly confined to specialist paediatric centres with anaesthesia required for a heterogenous range of conditions. One-lung ventilation may often be required, and knowledge of the techniques used for the varying size of the paediatric airway is essential. The impact of patient positioning, surgical retraction of the lung and the underlying disease process poses further challenges to the paediatric anaesthetist. This chapter covers management of the most common paediatric specific disease processes, including congenital and acquired lung abnormalities, intrathoracic masses, intrapleural collections and pectus surgery with an emphasis on lung isolation techniques and perioperative analgesia, including regional anaesthesia.

General anaesthesia is the reversible loss of consciousness induced by pharmacological agents. Surgeries were previously often limited to superficial procedures and amputations due to significant patient discomfort. This chapter provides an overview of the conduct of general anaesthesia, and its various phases: induction, maintenance, and emergence. Core concepts such as depth of anaesthesia and perioperative care will also be reviewed. Anaesthetic adjuncts, drugs, and equipment will also be discussed due to their crucial role in ensuring patient safety during general anaesthesia.

This chapter provides a detailed overview of the cardiovascular system in the context of perioperative care. The cardiovascular system is responsible for the delivery of oxygen around the body and the return of this blood to the heart. This blood is then pumped to the lungs and back to the heart. The systemic and pulmonary circulations have a number of important differences between them. The heart beats repeatedly in a process known as the cardiac cycle, which has two distinct phases, systole, and diastole. The conduction system of the heart allows for the chambers of the heart to contract in a well-coordinated manner. Problems with the cardiovascular system occur frequently under anaesthesia and can have numerous causes, some of which are explored in this chapter.