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(i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the <jats:italic>potential neurotoxicity associated with the exposure to anesthetics<\/jats:italic>. (ii) In children without relevant preexisting illnesses (ie, <jats:styled-content style=\"fixed-case\">ASA<\/jats:styled-content> status I\/<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>) who are scheduled for elective minor or medium\u2010risk surgical procedures, no <jats:italic>routine blood tests<\/jats:italic> should be performed. (iii) <jats:italic>Parental presence<\/jats:italic> during the induction of anesthesia should be an option for children whenever possible. (iv) <jats:italic>Perioperative fasting<\/jats:italic> should be safe and child\u2010friendly with shorter real fasting times and more liberal postoperative drinking and enteral feeding. (v) <jats:italic>Perioperative fluid therapy<\/jats:italic> should be safe and effective with physiologically composed balanced electrolyte solutions to maintain a normal extracellular fluid volume; addition of 1%\u20102.5% glucose to avoid lipolysis, hypoglycemia, and hyperglycemia, and colloids as needed to maintain a normal blood volume. (vi) To achieve safe and successful <jats:italic>airway management,<\/jats:italic> the locally accepted airway algorithm and continued teaching and training of basic and alternative techniques of ventilation and endotracheal intubation are required. (vii) Ultrasound and imaging systems (eg, transillumination) should be available for achieving <jats:italic>central venous access<\/jats:italic> and challenging peripheral venous and arterial access. (viii) Perioperative disturbances of the patient's <jats:italic>homeostasis,<\/jats:italic> such as hypotension, hypocapnia, hypothermia, hypoglycemia, hyponatremia, and severe anemia, should not be ignored and should be prevented or treated immediately. (ix) Pediatric patients with an elevated perioperative risk, eg, preterm and term neonates, infants, and critically ill children, should be treated at institutions where all caregivers have sufficient <jats:italic>expertise<\/jats:italic> and continuous clinical exposure to such patients. (x) A strategy for preventing <jats:italic>postoperative vomiting, emergence delirium<\/jats:italic>,<jats:italic> and acute pain<\/jats:italic> should be a part of every anesthetic procedure.<\/jats:p>","DOI":"10.1111\/pan.13383","type":"journal-article","created":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T05:44:28Z","timestamp":1527745468000},"page":"588-596","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Choosing Wisely in pediatric anesthesia: An interpretation from the German Scientific Working Group of Paediatric Anaesthesia (<scp>WAKKA<\/scp>)"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3781-8282","authenticated-orcid":false,"given":"Karin","family":"Becke","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Cnopf Children's Hospital\/Hospital Hallerwiese N\u00fcrnberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Eich","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Paediatric Intensive Care and Emergency Medicine Auf der Bult Children's Hospital Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"H\u00f6hne","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Hospital Leipzig Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7573-0302","authenticated-orcid":false,"given":"Martin","family":"J\u00f6hr","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Luzerner Kantonsspital Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Machotta","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Sophia Children's Hospital Erasmus MC Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0592-3632","authenticated-orcid":false,"given":"Markus","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology University Hospital Ulm Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5850-7443","authenticated-orcid":false,"given":"Robert","family":"S\u00fcmpelmann","sequence":"additional","affiliation":[{"name":"Clinic for Anaesthesiology and Intensive Care Medicine Hannover Medical School Hannover Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,5,30]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Choosing Wisely.An initiative of the ABIM Foundation. 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