Message from Director of the Department
This department is charge of anesthetic and perioperative management in the Pediatric Medical Center established as a “last defense” in pediatric medicine at Okayama University Hospital. It has worked with many anesthetic cases, including high-risk cardiac anesthesia, as conducted at children’s hospitals. It has had an increasing number of opportunities to provide state-of-the-art medical care, including many cases of analgesia or sedation and high-risk pediatric anesthesia. The Department of Pediatric Anesthesiology strives to meet the needs as a part of the “last defense” and provides safe and patient-friendly anesthetic care.
Pediatric Anesthesiology DepartmentTatsuo Iwasaki
Scope of Target Disease
Keeping safe, reliable and patient-friendly service in mind, it performs perioperative management to respond to all the cases: MRI and CT examinations, surgeries for abdominal fissure and congenital diaphragmatic hernia, and open-heart operation for complex cardiac anomaly including single ventricle and transportation of the great arteries. Additionally, the Department has many experiences of intensive care for patients in a severe condition, including postoperative follow-up management, showing good performance in cooperation with other specialties.
Features and Description of Medical Care
Analgesia and sedation
In examinations requiring delicate procedures such as a cardiac catheter tests and MRI and CT examinations, patients must be placed at rest for a certain period to prevent unexpected body motion. Therefore, it is also necessary for a child patient that analgesia and sedation be performed using drugs. Long rest and sufficient pain alleviation are necessary for examinations and treatments to be provided on a safe, certain, and patient-friendly basis. For patients with severe diseases, respiratory and cardiovascular management are performed actively so that the patients can safely undergo examinations and procedures.
Anesthesia and perioperative management
More than adult anesthesia, pediatric anesthesia has a higher risk of perioperative complication. Furthermore, specificities of children themselves and pediatric diseases demand different knowledge and techniques from adult anesthesia, as they do for all physicians of other departments that target children’s diseases. Pediatric anesthesiologists with sufficient knowledge and experience of pediatric anesthesia perform preoperative whole-body management as needed before the surgery, administer appropriate anesthesia to child patients, who will undergo surgeries in various surgical specialties depending on their disease conditions, and perform postoperative acute whole-body management in severe cases.
Intensive care management
While providing perioperative management for child patients from the departments of pediatric cardiac surgery, pediatric surgery, and pediatric cerebral surgery, a pediatric anesthesiologist experienced in intensive care performs intensive care on a round-the-clock basis for severe patients referred by the various departments of the Okayama University Hospital and other hospitals in cooperation with each department. We perform whole-body management including specialized treatments such as nitric oxide inhalation therapy nitrogen inhalation therapy; hypothermia; extracorporeal membrane oxygenation (ECMO)l continuous blood purification therapy; peritoneal dialysis for child patients with severe respiratory failure caused by cardiac failure and pneumonia, septic shock, for acute encephalitis and encephalopathy; and hematological malignancy for children after cardiopulmonary arrest.