Pediatric anesthesia - potential risks and their assessment: part I.

Despite a decline in mortality in pediatric anesthesia during the last two decades, publications still highlight the high incidence of perioperative morbidity that could definitely be decreased in the presence of a thorough preoperative assessment and preparation. Although the majority of children undergoing anesthesia is healthy, it is crucial to detect any underlying risk factor that may lead to an unexpected adverse event in the perioperative period. However, preoperative assessment should not involve a number of unnecessary tests which engender a stressful environment for the child and the family prior to anesthesia. Thus, this review highlights the potential risks encountered in the children and directs the preoperative assessment towards selecting essential tests based on the identified individual risk factors. Furthermore, advice is given regarding preoperative preparation and actions to be taken in an attempt to optimize a child’s ‘fitness’ for anesthesia and surgery.