When choosing a method of analgesia, the child’s age, previous pain experiences, type of surgery, expected pain intensity and duration should be considered. (1C)

Information related to baseline blood pressure, the presence of neurological deficits, and preexisting endorgan injury may influence intraoperative mean arterial blood pressure targets which must be individualized to the patient. (C-EO, Class I)

Preparation and allocation of resources for transfusion should be considered for the following high-risk groups: age over 50 years, preoperative anemia, multilevel/revision/tumor/deformity/trauma surgeries, and surgeries involving transpedicular osteotomy. (B-NR, Class I)

Whenever possible, a comprehensive preadmission/ preoperative assessment should be performed in patients undergoing complex surgeries. (C-EO, Class I)

Nil per os should follow American Society of Anesthesiologists (ASA) guidelines, and patients should consume a commercially available carbohydrate drink at least 2 hours before the planned procedure start time. (C-EO, Class I)

To reduce postoperative opioid use and improve patient satisfaction, and with careful patient selection and appropriate postoperative neurological and respiratory monitoring, neuraxial techniques (epidural/ spinal), or use of intrathecal opioids may be considered an adjunct. (C-EO, Class I)

The usefulness of non-neuraxial regional anesthesia is not well-established. (C-LD, Class IIb)

Volatile anesthesia or TIVA, or a combination, may be utilized based on patient considerations when not utilizing IONM. (B-NR, Class IIb)

Serial intraoperative and postoperative glucose monitoring using an intravenous insulin algorithm may be useful to maintain blood glucose <180 mg/dL in diabetic patients. (C-EO, Class I)

Whenever possible, periodic position checks must be performed in patients undergoing major complex spine surgery. (C-EO, Class I)