Invasive monitors are usually required. Intra-arterial monitoring is reserved for small children undergoing anastamosis of the allograft to the great vessels. Older children undergoing anastamosis to the iliac vessels do not require arterial monitoring, and in fact it should be avoided in order to preserve sites for future arteriovenous fistulae. CVP monitoring is required for all patients in order to guide volume management and for postoperative vascular access. Place a triple-lumen CVP line in a jugular or subclavian vein.
All patients have bladder catheters inserted prior to surgery.
Routine sedative premedication is appropriate. The goal of induction of anesthesia, as for all patients, is to protect against the risk of aspiration and to minimize cardiovascular changes. The induction technique is therefore tailored to the medical conditions of the patient. Maintenance of anesthesia. Most patients will benefit from concomitant epidural local anesthetics epidural opiates.