Anesthesia for Pediatric Interventional Radiology

Pediatric Interventional Radiology (IR) is progressively expanding and gaining popularity as it provides minimally invasive procedures and treatments, with very good outcomes and low adverse event rates. The image-guided body procedures include central venous access, gastrointestinal procedures, such as gastrostomy tubes, biopsies of solid organs and tumors, pleural and abdominal drain placements, endovascular procedures, and embolizations. Pediatric patients who require IR are often medically complex and have significant pathophysiological derangements. Pediatric IR intersects with multiple specialties, including Oncology, Transplant, General Surgery, Genetic Metabolic Diseases, Neurology, and Infectious Diseases. Anesthesiologists play a key role in IR, ensuring safe and effective care, often under complex clinical circumstances. The purpose of this review is to outline key practical considerations in the anesthetic management of pediatric IR, in particular body procedures. We present aspects of the pre-procedure evaluation and preparation and an overview of the IR technique, including considerations about agents commonly used in radiology, and we describe peri-operative considerations, anticipated challenges, and potential complications. Anesthesiologists will learn about image-guided body procedures and peculiarities of the anesthetic management, expanding their familiarity, and gaining confidence with pediatric cases in the IR environment.