Pediatric Cardiac Anesthesiology Dr. Jay Shapiro, Director
	It has long been know that infants and children are not small adults. Nowhere is this more apparent than when dealing with pediatric patients with congenital heart disease (CHD). The structural and functional differences make Emily - Complete Atrioventricular (AV) Septal Defect them quite different from the adult cardiac patient with ischemic heart disease. It is important that the anesthesiologist caring for your child has training and experience in managing patients with CHD. The Department of Anesthesiology has a separate Division of Pediatric Anesthesia made up of individuals with interest as well as extensive training and experience in managing patients as small as one pound to well over two hundred pounds with CHD who are undergoing evaluation and or repairs at the Children's Heart Center of MCVH.
	One program, unique in this area is the extensive use of regional analgesia (e.g.. epidural analgesia) in pediatric patients undergoing surgical repair of CHD. Building on the experience of associates at the University of Michigan and other academic medical centers, our program as come to rely on continuous epidural analgesia (CEA) as an adjunct both intraoperatively and into the postoperative period. The use of CEA provides a means of providing good to excellent pain relief without the sedating side effects of systemic pain drugs traditionally given in the past. Another benefit is that patients can be returned to unassisted breathing much earlier in their postoperative course, decreasing intensive care unit requirements and total hospital stay with significant improvement in patient comfort and care. Potential risks of this procedure include infection, bleeding, and concern for epidural hematoma (though none has been reported, to date, from any center in the country utilizing this technique). While this technique is not suited to all patients, it is just one example of the variety of innovative techniques utilized by members of the Division of Pediatric Anesthesia.
	For more information about MCV's Division of Pediatric Anesthesia call (804) 828-9160, or contact Dr. Shapiro at jshapiro@hsc.vcu.edu.

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