Caregiver anxiety and the association with acute post-operative pain in children undergoing elective ambulatory surgery in a lower-middle-income country setting.
This study aims to determine if there is an association between caregiver's pre-operative anxiety and children's post-operative pain in a lower-middle income country (LMIC) setting. METHODS: In this cross-sectional, descriptive study, we recruited 76 children aged 4 to 12 years, undergoing elective ambulatory tonsillectomy or adenotonsillectomy. Primary caregivers completed validated measures of anxiety (the Beck Anxiety Inventory [BAI] and the Kessler Psychological Distress Scale [K10]) prior to the children undergoing surgery. Post-operative pain was measured using the Wong Baker Faces Pain Rating Scale 4 hours afte...
Source: Paediatric Anaesthesia - June 27, 2020 Category: Anesthesiology Authors: Knoetze R, Lachman A, Moxley K, Chetty S Tags: Paediatr Anaesth Source Type: research

Predictors for failure of supraglottic superimposed high frequency jet ventilation during endoscopic upper airway surgery in pediatric patients.
Abstract Airway surgery in pediatric patients is challenging with regard to balancing surgical exposure with ventilation requirements, as during the procedure the airway must be shared between laryngologist and anesthetist. For endoscopic laryngeal surgery, different methods of ventilation are used, among others jet ventilation via a specifically adapted suspension laryngoscope using a dual jet stream(Supraglottic Superimposed High Frequency Jet ventilation, SSHFJV) (1).High BMI and a history of pulmonary pathology proved to be factors contributing to failing of SSHFJV in adult patients (2). However, factors influ...
Source: Paediatric Anaesthesia - June 21, 2020 Category: Anesthesiology Authors: Plate C, Krenz G, Molenbuur B, Dikkers FG, Eindhoven GB, Wachters JE, van Dijk B, Halmos GB Tags: Paediatr Anaesth Source Type: research

Anesthesia and potential aerosol generation during Magnetic Resonance Imaging in Children with COVID-19.
We describe our experience for children requiring anesthesia for emergency MRI during the COVID-19 outbreak in Philadelphia. PMID: 32564492 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - June 21, 2020 Category: Anesthesiology Authors: Drum E, McClung Pasqualino H, Subramanyam R Tags: Paediatr Anaesth Source Type: research

The "Mother of Pediatric Cardiac Anesthesia": An interview with Dr. Dolly D. Hansen, A Pioneering Woman in Medicine.
The "Mother of Pediatric Cardiac Anesthesia": An interview with Dr. Dolly D. Hansen, A Pioneering Woman in Medicine. Paediatr Anaesth. 2020 Jun 19;: Authors: Odegard KC, Rockoff MA Abstract Dr. Dolly D. Hansen (1935-), Associate Professor in the Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, devoted her life to improving the perioperative care of children with congenital heart disease (CHD). She applied her knowledge of cardiovascular and pulmonary physiology and the effects on anesthetic agents in children with and witho...
Source: Paediatric Anaesthesia - June 19, 2020 Category: Anesthesiology Authors: Odegard KC, Rockoff MA Tags: Paediatr Anaesth Source Type: research

Infant peripherally inserted central catheter insertion without general anesthesia.
CONCLUSIONS: Infants younger than 6 months and under 5.5 kg can be managed withoutgeneral anesthesia for peripherally inserted central catheterinsertion using a Fast, Feed and Wrap technique. PMID: 32557975 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - June 18, 2020 Category: Anesthesiology Authors: Laing S, Burgoyne LL, Muncaster M, Taranath A, Taverner FJ Tags: Paediatr Anaesth Source Type: research

Impact of clear fluids fasting on pulmonary aspiration in children undergoing general anesthesia: Results of the German prospective multicenter observational (NiKs) study.
, Eich C, Sümpelmann R Abstract BACKGROUND: A preliminary national audit of real fasting times including 3324 childrenshowed that the fasting times for clear fluids and light meals were frequently shorter than recommended in current guidelines, but the sample size was too small for subgroup analyses. AIMS: Therefore,the primary aim of this extended study with more participating centers and a larger sample sizewas to determine whether shortened fasting times for clear fluids or light meals have an impact on the incidence of regurgitation or pulmonary aspiration during general anesthesia in children. ...
Source: Paediatric Anaesthesia - June 13, 2020 Category: Anesthesiology Authors: Beck CE, Rudolph D, Mahn C, Etspüler A, Korf M, Lüthke M, Schindler E, Päukert S, Trapp A, Megens JHAM, Oppitz F, Badelt G, Röher K, Genähr A, Fink G, Müller-Lobeck L, Becke-Jakob K, Wiener R, Boethig D, Eich C, Sümpelmann R Tags: Paediatr Anaesth Source Type: research

Use of Dexmedetomidine and Opioids as the Primary Anesthetic in Infants and Young Children: A Retrospective Cohort Study.
Abstract BACKGROUND: Anesthetic regimens using dexmedetomidine and short acting opioids have been suggested as potential alternatives to sevoflurane-based anesthesia in children. The primary aim of this study is to compare demographics, intraoperative characteristics, and complications of general anesthetics in which dexmedetomidine and opioids were used without sevoflurane, or in combination with a low sevoflurane concentration, in children 36 months old and younger. The secondary aim is to evaluate intraoperative bispectral index (BIS) values when available in these patients. METHODS: General anesthetics pe...
Source: Paediatric Anaesthesia - June 8, 2020 Category: Anesthesiology Authors: Efune PN, Longanecker JM, Alex G, Saynhalath R, Khan U, Rivera K, Jerome AP, Boone W, Szmuk P Tags: Paediatr Anaesth Source Type: research

A retrospective cohort study of adverse event assessment during anesthesia-related proceduresfor cochlear implant candidacy assessment and cochlear implantationin infants and toddlers.
CONCLUSIONS: Adverse events occur independent of the age at implantation,the number of anesthetic preoperative procedures and the type of anesthetic maintenance agent in patientswho received a cochlear implant before 24 months of age. PMID: 32506586 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - June 7, 2020 Category: Anesthesiology Authors: Bruijnzeel H, Wammes E, Stokroos RJ, Topsakal V, de Graaff JC Tags: Paediatr Anaesth Source Type: research

Effects of hypothermia and hypothermia combined with hypocapnia on cerebral tissue oxygenation in piglets.
Abstract BACKGROUND: Hypothermia and its combination with hypocapnia are frequently associated with anesthesia. AIMS: The goal was to investigate the effects of hypothermia and hypothermia combined with hypocapnia (hypothermia-hypocapnia) on cerebral tissue oxygenation in anesthetized piglets. METHODS: Twenty anesthetized piglets were randomly allocated to hypothermia (n = 10) or hypothermia-hypocapnia (n = 10). Cerebral monitoring comprised a tissue oxygen partial pressure (PtO2 ), a laser Doppler probe and a near-infrared spectroscopy sensor, measuring regional oxygen saturation (rSO2 ). After baseline...
Source: Paediatric Anaesthesia - June 7, 2020 Category: Anesthesiology Authors: Ringer SK, Clausen NG, Spielmann N, Weiss M Tags: Paediatr Anaesth Source Type: research

Ventilation in pediatric anesthesia: A French multicenter prospective observational study (PEDIAVENT).
'Expression Française) Abstract INTRODUCTION: Protective ventilation is now a standard of care in adults. However, management of ventilation is heterogeneous in children and little is known regarding the mechanical ventilation parameters actually used during pediatric anesthesia. AIM: The aim of the study was to assess current ventilatory practices during pediatric anesthesia in France and to compare them with pediatric experts' statements, with a specific focus on tidal volume. PATIENTS AND METHODS: We conducted a prospective multicenter observational study, regarding the ventilatory management a...
Source: Paediatric Anaesthesia - June 5, 2020 Category: Anesthesiology Authors: Lebossé M, Kern D, De Queiroz M, Bourdaud N, Veyckemans F, Chassard D, Baudin F, ADARPEF (Association Des Anesthésistes Réanimateurs Pédiatriques d'Expression Française) Tags: Paediatr Anaesth Source Type: research

Post-operative pain and psychological outcomes following minimally invasive pectus excavatum repair: A report from the Society for Pediatric Anesthesia Improvement Network.
In this study, we examined the relationship between immediate postoperative pain and psychological outcomes at two weeks and three months after discharge in a cohort of pediatric patients who underwentMIRPE. We sought to determine ifimmediate postoperative pain levels were associated with ongoing distress related to aspects of surgery at both time points. We were also interested in how psychological symptoms related to persistent pain concerns. METHODS: Data on patients undergoing MIRPE across 14 institutions was collected as part of the Society for Pediatric Anesthesia Improvement Network (SPAIN). Patients were conta...
Source: Paediatric Anaesthesia - June 3, 2020 Category: Anesthesiology Authors: Uhl KM, Wilder RT, Fernandez A, Huang H, Muhly WT, Zurkowski D, Cravero JP Tags: Paediatr Anaesth Source Type: research

How should we approach parental refusals of opioids on behalf of children in the perioperative setting? A practical approach based on ethical theory.
This article describes ethical theory related to the refusal of treatment by parents on behalf of their children, and when it is justified to override parental decisions. We propose a decision-making framework that focuses on improving communication and considering alternatives. Assessment of harm to the child from avoiding opioids, as well as potential harms from overriding parental autonomy must be undertaken prior to considering overriding parents. PMID: 32485043 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - June 2, 2020 Category: Anesthesiology Authors: Moreno-Galvan A, Marron JM, Marsiglio AM Tags: Paediatr Anaesth Source Type: research

The Physiological Effect of 1MAC Sevoflurane with or without 50% Xenon in Immature Rats.
Abstract Anesthetic-induced neurodegenerationin rats occursacross the first three postnatal weeks1 (human equivalent:fetus to pre-schooler), during which the central nervous system, respiratory control and pharmacodynamics undergo hugechanges. In immature rats, hypercarbia alone(mimicking isoflurane anesthesia-induced hypercarbia) induced neurodegeneration2 and Xenon reducesanesthetic-induced neurodegeneration. PMID: 32476187 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - June 1, 2020 Category: Anesthesiology Authors: Bountra K, Gill H Tags: Paediatr Anaesth Source Type: research

Exhaled Nitric Oxide Measurement before Pediatric Adenotonsillectomy: A Feasibility Study.
Abstract BACKGROUND: Exhaled nitric oxide (eNO) is a known biomarker for the diagnosis and monitoring of bronchial hyperreactivityin adults and children. AIMS: To investigatethe potential role of eNOmeasurement for predicting perioperative respiratory adverse events in children, we sought to determine its feasibility and acceptability before adenotonsillectomy. METHODS: We attempted eNO testing in children, 4 to 12 years of age, immediately prior to admission for outpatient adenotonsillectomy. We used correlations between eNO levels and postoperative adverse respiratory events to make sample size predict...
Source: Paediatric Anaesthesia - June 1, 2020 Category: Anesthesiology Authors: Jablonka DH, Nishisaki A, Feldman JM, Galvez JA, Gurnaney HG, Rizzi MD, Simpao AF, Subramanyam R, Litman RS Tags: Paediatr Anaesth Source Type: research

Emergence delirium in children undergoing dental surgery under general anaesthesia.
Abstract BACKGROUND: Emergence delirium is a well described complication in paediatric anaesthesia, occurring more often following short surgical procedures using volatile anaesthetics with a rapid recovery profile. Dental extractions and conservation dentistry are commonly performed in children and are not painful postoperatively. The use of nerve blocks and local anaesthetic infiltration intraoperatively limits nociception and obviates the need for opioids, allowing for more objective assessment of emergence delirium. AIM: The purpose of this preliminary study was to describe the incidence of emergence deli...
Source: Paediatric Anaesthesia - May 29, 2020 Category: Anesthesiology Authors: Jooma Z, Perrie H, Scribante J, Kleyenstuber T Tags: Paediatr Anaesth Source Type: research

I'm afraid!Children's Experiences of Being Anesthetized.
CONCLUSION: The reasons for children experiencing anxiety when being anesthetized are multifaceted and this study highlights the importance of listening to each child's own voice and striving to create an individually adapted caring and safe environment with as much protection as possible. PMID: 32463955 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 28, 2020 Category: Anesthesiology Authors: Andersson L, Karlsson K, Johansson P, Almerud Österberg S Tags: Paediatr Anaesth Source Type: research

Intravenous cannula placement in children for induction of general anesthesia: prospective audit and identification of success factors.
CONCLUSIONS: Cannulation for planned IV induction is feasible for most children, enabling increased use of total intravenous anesthesia as an institutional anesthetic strategy. PMID: 32464692 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 28, 2020 Category: Anesthesiology Authors: Hügel C, Chen J, Poznikoff AK, West NC, Reimer E, Görges M Tags: Paediatr Anaesth Source Type: research

Enclosure with augmented airflow to decrease risk of exposure to aerosolized pathogens including coronavirus during endotracheal intubation. Can the reduction in aerosolized particles be quantified?
We report preliminary experience with the efficacy of an enclosure with augmented airflow to decrease the risk of exposure to aerosolized pathogens during airway management including endotracheal intubation. A particle generator was used to test the efficacy of the reduction of aerosolized particles by measuring their concentration within the enclosure and in the environment. No reductionin the concentration of aerosolized particles was noted with the enclosure flap open, whether the interior suction was on or off. However, with the enclosure closed and no augmented air flow (suction off), the particle concentration decrea...
Source: Paediatric Anaesthesia - May 28, 2020 Category: Anesthesiology Authors: Bryant J, Tobias JD Tags: Paediatr Anaesth Source Type: research

A Retrospective Cohort Study of Predictors and Interventions  that Influence Cooperation with Mask Induction in Children.
CONCLUSION: In this cohort, increasing age was the only patient characteristic found to be associated with increased cooperation with mask induction. Preoperative intervention by a Child Life Specialists was the sole intervention associated with improved cooperation. PMID: 32452092 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 25, 2020 Category: Anesthesiology Authors: Marquez JL, Wang E, Rodriguez ST, O'Connell C, Munshey F, Darling C, Tsui B, Caruso J, Caruso TJ Tags: Paediatr Anaesth Source Type: research

Feasibility of the ultrasound-guided supraclavicular cannulation of the brachiocephalic vein in very small weight infants: A case series.
CONCLUSION: Supracalvicular in-plane real-time ultrasound-guided cannulation of the brachiocephalic vein seems to be a convenient and feasible option to provide large-bore central venous access for very small and sick babies. PMID: 32449570 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 25, 2020 Category: Anesthesiology Authors: Breschan C, Graf G, Arneitz C, Stettner H, Feigl G, Neuwersch S, Stadik C, Koestenberger M, Holasek S, Likar R Tags: Paediatr Anaesth Source Type: research

Anesthetic Management and Outcomes For MRI-Guided Laser Interstitial Thermal Therapy (LITT) For Seizure Focus in Pediatrics: A Single Centre Experience With 10 Consecutive Patients.
Abstract MRI-guided laser interstitial thermal therapy (LITT) is a stereotactically guided percutaneous minimally invasive procedure, which delivers light energy to tissue via a fiberoptic catheter, resulting in selective thermal ablation. Its use in drug-resistant epilepsy has increased because safety and efficacy have been well-established in adult and pediatric populations 1-4 . The anesthetic management of this procedure in children has not been previously reported. In our pediatric institution, MRI guided LITT is performed using the Visualase™ system (Medtronic, Minneapolis, MN). The typical procedural ...
Source: Paediatric Anaesthesia - May 23, 2020 Category: Anesthesiology Authors: Levin DN, McClain CD, Stone SSD, Madsen JR, Soriano S Tags: Paediatr Anaesth Source Type: research

Dependency of respiratory system mechanics on positive end-expiratory pressure and recruitment maneuvers in lung healthy pediatric patients - a randomized crossover study.
CONCLUSIONS: We conclude that contrary to our hypothesis, positive end-expiratory pressure up to 7 cm H2 O is not sufficient to resolve tidal derecruitment and that recruitment maneuvers may be dispensable in mechanically ventilated pediatric patients. PMID: 32445609 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 23, 2020 Category: Anesthesiology Authors: Schumann S, Feth A, Borgmann S, Wirth S Tags: Paediatr Anaesth Source Type: research

Flow irregularities from syringe infusion pumps caused by syringe stiction.
CONCLUSION: Infusion set rate rather than syringe brand or filling volume was a major predictor for syringe stiction-related amount of variation in the calculated plasma epinephrine concentration. PMID: 32443169 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 22, 2020 Category: Anesthesiology Authors: Peduzzi N, Batliner M, Grass B, Buehler PK, Schmid Daners M, Meboldt M, Weiss M Tags: Paediatr Anaesth Source Type: research

Anesthetic concerns for pediatric patients in the era of COVID-19.
This article addresses specific concerns for the anesthetic management of the pediatric population with COVID-19. PMID: 32438527 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 21, 2020 Category: Anesthesiology Authors: Soneru CN, Nunez K, Petersen TR, Lock R Tags: Paediatr Anaesth Source Type: research

Intravenous Dexmedetomidine Sedation for Magnetoencephalography: A Retrospective Study.
CONCLUSIONS: Our results suggest that dexmedetomidine-based protocol provides reliable sedation in children undergoing MEG scanning because of the high success rate, limited interictal artifacts, and minimal impacts on spike frequency. PMID: 32436319 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 20, 2020 Category: Anesthesiology Authors: Tewari A, Mahmoud M, Rose D, Ding L, Tenney J Tags: Paediatr Anaesth Source Type: research

Reducing paediatric exposure to environmental tobacco smoke: the effects of paediatric exposure to environmental tobacco smoke and the role of paediatric peri-operative care.
This article describes the scale of the population of children exposed to ETS and the risks to their general and their peri-operative health. We explore the concept of a "teachable moment" in peri-operative medicine;an ideal opportunity to deliver a public health intervention at a time where families feel motivated to make a behavioural change.Thus we may improve not only the child's peri-operative outcome but also their general health, and that of their family, beyond the planned procedure. PMID: 32395863 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 12, 2020 Category: Anesthesiology Authors: Riley C, Ladak N Tags: Paediatr Anaesth Source Type: research

Perioperative management of children with urea cycle disorders.
CONCLUSIONS: Procedures under anesthesia on pediatric patients with urea cycle diseases should be performed by experienced multidisciplinary teams at specialized centers. Perioperative management focused on avoiding catabolism (especially during fasting) and monitoring signs associated with metabolic decompensation to allow for its early treatment should be included in routine anesthetic techniques for children with urea cycle disorders. PMID: 32375202 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - May 6, 2020 Category: Anesthesiology Authors: Del Río C, Martín-Hernández E, Ruiz A, Quijada-Fraile P, Rubio P Tags: Paediatr Anaesth Source Type: research

The Effect of Intraoperative Methadone During Pediatric Cardiac Surgery on Postoperative Opioid Requirements.
Abstract BACKGROUND: Pain control in pediatric patients undergoing cardiac surgery presents a unique challenge. Postoperatively, many of these patients require long-term opioid infusions and sedation leading to need for prolonged weaning from opioids and longer hospital stays. We hypothesized that intravenous methadone as the sole opioid in children having cardiac surgery with cardiopulmonary bypass would improveperioperative pain control anddecrease overall perioperative use of opioid analgesics and sedatives. METHODS: We instituted a practice change involvingpediatric patients age
Source: Paediatric Anaesthesia - May 4, 2020 Category: Anesthesiology Authors: Barnett AM, Machovec KA, Ames WA, Homi HM, Turi JL, Koo J, Fuller M, Jooste EH Tags: Paediatr Anaesth Source Type: research

Respiratory and haemodynamic perioperative adverse events in intravenous versus inhalational induction in paediatric anaesthesia: a systematic review and meta-analysis.
Abstract Perioperative respiratory and haemodynamic adverse events are still a cause of morbidity and mortality in paediatric anaesthesia. It has been suggested that volatile agents might be associated with more respiratory adverse events compared to intravenous agents (e.g., propofol), which have been associated with a higher risk of bradycardia compared to volatile agents. We performed a systematic review and meta-analysis to evaluate the risk of perioperative haemodynamic and respiratory adverse events, comparing intravenous induction with inhalational induction in paediatric anaesthesia. We searched PubMed, Em...
Source: Paediatric Anaesthesia - May 1, 2020 Category: Anesthesiology Authors: Blaauwendraad SM, Porter LL, Pieters BM Tags: Paediatr Anaesth Source Type: research

Anesthetic Management of Pediatric Patients with Niemann-Pick Disease Type C for Intrathecal 2-hydroxypropyl- β-cyclodextrin Injection.
CONCLUSIONS: Our findings suggest that general anesthesia induced via inhalation induction and maintained with volatile anesthetic via mask or supraglottic airway is a safe andeffective option for pediatric patients with Niemann-Pick disease type C undergoing serial intrathecal injections of 2-hydroxypropyl-beta-cyclodextrin, supporting thistechnique as a viable option for anesthetic care in these patients. PMID: 32349180 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 29, 2020 Category: Anesthesiology Authors: Ulloa ML, Froyshteter AB, Kret LN, Chang DP, Sarah GE, McCarthy RJ, Barnes SD, Berry-Kravis EM Tags: Paediatr Anaesth Source Type: research

Incidence and risk factors of preoperative anxiety in Spanish-speaking children living in a Spanish-speaking country.
CONCLUSIONS: Spanish-speaking children undergoing elective surgery in their home country experienced significant rates of preoperative anxiety. Parental anxiety and previous negative surgical experience were risk factors associated with higher anxiety levels. PMID: 32343016 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 28, 2020 Category: Anesthesiology Authors: Arze S, Lagos C, Ibacache M, Zamora M, González A Tags: Paediatr Anaesth Source Type: research

Characterizing the cephalic vein as a blind cannulation target in infants.
Abstract Infants requiring anesthesia often require intravenous access (IV). However, IV access may be difficultbecause of small vessels. Cannulation of larger veins such as thesaphenous vein have been described in the literature (1). A potential alternative to the saphenous is the cephalic vein (CV), which has been utilized in the deltopectoral trianglefor central access, pacemaker implantation, and defibrillator implantation (2). The purpose of this study is to better characterize the CVin children 1 year old or less for potential as a blind cannulationsite. PMID: 32343018 [PubMed - as supplied by publisher...
Source: Paediatric Anaesthesia - April 28, 2020 Category: Anesthesiology Authors: Lam HV, Nyshadham S, Edney J, Austin T Tags: Paediatr Anaesth Source Type: research

Lung protective ventilation in infants undergoing cardiopulmonary bypass surgery for congenital heart disease: a prospective randomized controlled trial.
Abstract BACKGROUND: Lung protective ventilation (LPV) has been applied to surgical adults with normal pulmonary function for optimizing mechanic ventilation and reducing postoperative pulmonary complications. Few studies have reported the use of LPV in infants undergoing cardiac surgery with cardiopulmonary bypass (CPB). AIMS: To explore safety and effectiveness of LPV in infants undergoing CPB surgery for congenital heart disease (CHD). METHODS: Included in this study were 77 infants who underwent CPB surgery for CHD from November 2017 to September 2018. They were randomized into the LPV group and conv...
Source: Paediatric Anaesthesia - April 27, 2020 Category: Anesthesiology Authors: Sun Y, Shen SE, Deng XM, Cai Y, Du Y Tags: Paediatr Anaesth Source Type: research

Medical Simulation Utilization among Pediatric Anesthesiology Fellowship Programs.
CONCLUSIONS: Simulation-based curricula are broadly offered by many fellowship programs. Improved collaboration locally, regionally, and nationally may improve educational opportunities for fellowship programs, particularly the small ones. These efforts may begin with the development of a standardized curriculum and formal instructor training programs. PMID: 32335993 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 26, 2020 Category: Anesthesiology Authors: Ambardekar AP, Newell A, Blassius K, Waldrop WB, Young DA Tags: Paediatr Anaesth Source Type: research

Parental Perspectives on General Anesthesia Exposure in Young Children.
Abstract General Anesthesia (GA) exposure and the potential concern for neurotoxicity in children remains controversial. In 2017, European anesthesia societies emphasized the importance of counseling parents to balance the benefits of elective interventions requiring GA with potential risks of GA exposure. Studies on parental perspectives on the topic in the United States (U.S.) are lacking. We aimed to better understand parental concerns of GA exposure in young children in the U.S. PMID: 32333710 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 25, 2020 Category: Anesthesiology Authors: Chan YY, Rosoklija I, Meade P, Cheon EC, Benzon HA, Chu DI Tags: Paediatr Anaesth Source Type: research

Non-Opioid Analgesic Usage Among Pediatric Anesthesiologists: A Survey of Society for Pediatric Anesthesia Members.
Abstract There is growing evidence to support the perioperative use of non-opioid analgesic medications in the pediatric population,1 but the use of, and attitudes toward, these agents among pediatric anesthesiologists is unknown. In order to characterize utilization of opioid-sparing agents in pediatric anesthesia, we designed a survey to study usage patterns for several non-opioid adjuncts by members of the Society for Pediatric Anesthesia (SPA) during and in the 24 hours following procedures. PMID: 32323361 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 23, 2020 Category: Anesthesiology Authors: King MR, Wu RL, De Souza E, Newton MA, Anderson TA Tags: Paediatr Anaesth Source Type: research

Association of Tidal Volume during Mechanical Ventilation with Postoperative Pulmonary Complications in Pediatric Patients Undergoing Major Scoliosis Surgery.
This study examined whether postoperative pulmonary complications were related to tidal volume in this population and, if so, what factors affected the association. METHODS: In this retrospective cohort study, data from pediatric patients ( 3 years). Such information may help to optimize ventilation strategy for children of different ages. PMID: 32323398 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 23, 2020 Category: Anesthesiology Authors: Ren Y, Liu J, Nie X, Liu L, Fu W, Zhao X, Zheng T, Xu Z, Cai J, Wang F, Li L, Zhong X, Hua L, Hu J, Zhang J Tags: Paediatr Anaesth Source Type: research

A Survey of Current Practices of Informed Consent by Pediatric Anesthesiologists.
Abstract Informed consent is fundamental to the ethical practice of medicine and carries important legal implications. Of particular relevance to pediatric anesthesia is the Food and Drug Administration's Drug Safety Communication (DSC), which highlights potential yet theoretical adverse effects on brain development of repeated or prolonged anesthesia administration to children younger than 3 years of age. PMID: 32323407 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 22, 2020 Category: Anesthesiology Authors: Fernandez AM, Watkins SC, Clendenin DJ, Smith EB, Dolan JE, Amankwah E, Jalali A, Ahumada L, Nguyen ATH, Rehman M, Elliott RA Tags: Paediatr Anaesth Source Type: research

Perioperative aspiration events in children: a report from the Wake-Up Safe Collaborative.
CONCLUSION: Although infrequent, death was reported as a consequence of perioperative aspiration in 2 patients. The frequency with which NPO violations were identified as a potential cause of aspiration highlights the struggles institutions face with adherence to NPO regulations, as these cases may be preventable. Furthermore, preventive measures may be needed to address other common causes of aspiration, such as gastrointestinal comorbid conditions. PMID: 32319164 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 22, 2020 Category: Anesthesiology Authors: Pfaff KE, Tumin D, Miller R, Beltran RJ, Tobias JD, Uffman JC Tags: Paediatr Anaesth Source Type: research

Paediatric Anaesthetic implications of COVID-19 - A Review of Current Literature.
This article reviews the relevant paediatric literature surrounding COVID-19 and summarises the key recommendations for anaesthetists involved in the care of children during this pandemic. PMID: 32306440 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 19, 2020 Category: Anesthesiology Authors: Lee-Archer P, von Ungern-Sternberg BS Tags: Paediatr Anaesth Source Type: research

Electronic cigarettes: a narrative review of the implications for the pediatric anesthesiologist.
Abstract The use of electronic cigarettes (EC) is increasing and the number of EC publications is rapidly growing. While some health organizations focus on the harmful effects of using EC (vaping), others promote the benefits of ECs as a less harmful alternative to smoking tobacco. There is concern that vaping might have adverse respiratory consequences for pediatric patients facing anesthesia and intensive care. This narrative review summarises current knowledge and recommendations regarding the risks of EC relevant to the anesthesiologist and the use of ECs as a step-down option from tobacco. We provide guidance...
Source: Paediatric Anaesthesia - April 18, 2020 Category: Anesthesiology Authors: Lemay F, Baker P, McRobbie H Tags: Paediatr Anaesth Source Type: research

Airway management for dental clearance in a preschool child: A UK survey.
Abstract Dental extractions are one of the most common reasons for pediatric hospital admission (approximately 82,000 children undergo general anesthesia (GA) for dental procedures in the UK)1 . These cases are undertaken in a range of clinical settings from district general hospitals to specialist referral centres and dental hospitals. PMID: 32297693 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 16, 2020 Category: Anesthesiology Authors: Shrimpton AJ, Gill H Tags: Paediatr Anaesth Source Type: research

Perioperative apnea in infants with hypertrophic pyloric stenosis: a systematic review.
CONCLUSIONS: Infants with IHPS may have a risk to develop perioperative apnea. However, the incidence rates should be interpreted with caution because of the low quality and quantity of the studies. Therefore, further studies are required to determine the incidence of perioperative apnea in infants with IHPS. The precise underlying mechanism of apnea in these infants is still unknown and the role of metabolic alkalosis should be further evaluated. PMID: 32298502 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 16, 2020 Category: Anesthesiology Authors: van den Bunder FAIM, van Wijk L, van Woensel JBM, Stevens MF, van Heurn LWE, Derikx JPM Tags: Paediatr Anaesth Source Type: research

Cardiopulmonary resuscitation in pediatric pectus excavatum patients - where is the heart?
Abstract BACKGROUND: In children with pectus excavatum, the posteriorly depressed sternum compresses and displaces the heart. However, the currently recommended compression site and depth for cardiopulmonary resuscitation have not been studied in this population. AIM: This retrospective study investigated the location of the center of ventricles with the largest cross-sectional area to determine the optimal site and depth for chest compressions in pediatric pectus excavatum patients. METHODS: Chest computed tomography images of 94 pediatric pectus excavatum patients before and after correction surgery we...
Source: Paediatric Anaesthesia - April 16, 2020 Category: Anesthesiology Authors: Jang YE, Park JB, Kang CH, Park S, Kim EH, Lee JH, Kim HS, Kim JT Tags: Paediatr Anaesth Source Type: research

Anaesthesia for bilateral pulmonary banding as part of hybrid-stage I approach palliating neonates with hypoplastic left heart syndrome.
This study documents the anaesthetic challenges and potential complications associated with the Giessen hybrid stage I approach. METHODS: The Giessen hybrid stage I approach is focused on surgical bilateral pulmonary artery banding. Retrospective perioperative data were analysed. Contrary to a stable group A, inotropic treatment before surgery for treatment of postnatal shock classified patients as unstable (Group B). Clinical Outcomes considered were in-hospital mortality, duration of postoperative mechanical ventilation, postoperative time at the intensive care unit, perioperative vasoactive medication requirements,...
Source: Paediatric Anaesthesia - April 14, 2020 Category: Anesthesiology Authors: Zajonz T, Cupka P, Koerner C, Mann V, Menges T, Akintuerk H, Valeske K, Thul J, Schranz D, Mueller M Tags: Paediatr Anaesth Source Type: research

Continuous costoclavicular brachial plexus block in a pediatric patient for post-fracture rehabilitation.
Abstract The costoclavicular approach to the brachial plexus block has been recently described as a technique for anesthesia or post-operative analgesia of distal upper limb. In this article, we describe a case in which a continuous costoclavicular brachial plexus block was performed in a pediatric patient for conservative treatment of a traumatic radial fracture with severe elbow rigidity. Perineural catheter placement is a valuable option for pain control and functional prognosis during rehabilitation. PMID: 32285583 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - April 13, 2020 Category: Anesthesiology Authors: Regufe R, Artilheiro V, Dias MB, Miranda I, Cenicante T Tags: Paediatr Anaesth Source Type: research

Pediatric anesthesiologists' attitudes about neurotoxicity and the FDA drug safety communication.
Abstract The 2016 Food and Drug Administration (FDA) Drug Safety Communication states that brain development in children under 3 years old may be affected by "repeated or lengthy use of general anesthetic and sedation drugs" and advises healthcare providers to "discuss with parents, caregivers, and pregnant women the benefits, risks, and appropriate timing of surgery or procedures requiring anesthetic and sedation drugs." This preliminary study's aims were to explore 1) pediatric anesthesiologists' attitudes regarding the FDA statement, 2) the statement's impact on informed consent practices, a...
Source: Paediatric Anaesthesia - April 12, 2020 Category: Anesthesiology Authors: Gentry KR, Feldman R, Opel D Tags: Paediatr Anaesth Source Type: research

Longer upper airway lengths in Robin Sequence: a case control study using computed tomography.
Abstract BACKGROUND: Direct laryngoscopy and intubation are often difficult in children with Robin Sequence. Previous research characterizing anatomic airway differences has focused on parameters influencing airway patency; there is a paucity of data pertaining to intubation trajectories and depth. Such information could impact airway management approaches and decrease the incidence of endotracheal tube malpositioning. AIM: The study goal was to examine whether longitudinal airway parameters pertaining to intubation are different in children with Robin Sequence compared to age-matched controls. METHOD: T...
Source: Paediatric Anaesthesia - April 11, 2020 Category: Anesthesiology Authors: Perez FA, Hottinger DG, Evans KN, Giles M, Otto RK, Hunyady A, Gentry KR Tags: Paediatr Anaesth Source Type: research

Perioperative management of oral cleft repair: a retrospective chart review.
Abstract Pre-clinical evidence has shown all common anesthetic drugs are toxic to the developing brain1 . Despite numerous cohort studies and one randomised control trial (RCT)2 , it remains unclear whether anesthetic-induced neurotoxicity exists and if intraoperative physiological disturbance plays a role. Well-designed RCTs with long-term follow-up are required to examine this. Infants requiring repair of oral cleft may provide an optimal clinical model; they often undergo multiple surgeries and have routine, nationally agreed, long-term speech and language assessments which extend into early adulthood. PMI...
Source: Paediatric Anaesthesia - April 10, 2020 Category: Anesthesiology Authors: Shrimpton AJ, Gill H Tags: Paediatr Anaesth Source Type: research

The association between preoperative anaemia and postoperative morbidity in paediatric surgical patients: A secondary analysis of a prospective observational cohort study.
Abstract BACKGROUND: The prevalence of anaemia in the South African paediatric surgical population is unknown. Anaemia may be associated with increased postoperative complications. We are unaware of studies documenting these findings in patients in low- and middle-income countries (LMICs). AIM: The primary aim of this study was to describe the association between preoperative anaemia and 26 defined postoperative complications, in noncardiac paediatric surgical patients. Secondary aims included describing the prevalence of anaemia and risk factors for intraoperative blood transfusion. METHOD: This was a s...
Source: Paediatric Anaesthesia - April 10, 2020 Category: Anesthesiology Authors: Meyer HM, Torborg A, Cronje L, Thomas J, Bhettay A, Diedericks J, Cilliers C, Kluyts H, Mrara B, Kalipa M, Biccard B, SAPSOS investigators Tags: Paediatr Anaesth Source Type: research