Incidence of post-induction hypoxemia in children and the effect of induction gas composition
Paediatr Anaesth. 2021 Feb 22. doi: 10.1111/pan.14161. Online ahead of print.ABSTRACTBACKGROUND: Pediatric preoxygenation and inhalation induction of anesthesia can include a mixture of gases. In children, the clinical impact on oxygenation while using other gases with oxygen during an inhalation induction is unknown.AIM: We aimed to determine the impact of oxygen, nitrous oxide, and air concentrations added to the volatile agent by recording the incidence of hypoxemia following an inhalation gaseous induction in children.METHOD: Records from an Automated Information Management System were used to find the incidence of hyp...
Source: Paediatric Anaesthesia - February 22, 2021 Category: Anesthesiology Authors: David Cumin Paul A Baker Brian J Anderson Source Type: research

Cuffed endotracheal tubes in neonates and infants of less than 3 kg body weight - A retrospective audit
CONCLUSION: Half of the children weighing 2000-2999 g received a Microcuff® PET 3.0 mm ID, especially those with a body weight above 2700 g. Because of the anatomical dimensions in patients with a body weight of 2000-2999 g, cuffed tracheal tubes with smaller outer diameters may be required to better fit their airways.PMID:33615635 | DOI:10.1111/pan.14104 (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - February 22, 2021 Category: Anesthesiology Authors: D ésirée Zander Beate Grass Markus Weiss Philipp K Buehler Achim Schmitz Source Type: research

Best Abstracts for APA Online meeting 2020
Paediatr Anaesth. 2021 Feb 20. doi: 10.1111/pan.14109. Online ahead of print.NO ABSTRACTPMID:33608935 | DOI:10.1111/pan.14109 (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - February 20, 2021 Category: Anesthesiology Source Type: research

Statistics in Quality Improvement: Measurement and Statistical Process Control
Paediatr Anaesth. 2021 Feb 20. doi: 10.1111/pan.14163. Online ahead of print.ABSTRACTData are used in healthcare quality improvement endeavors to measure and determine if the changes made in the course of the work have made the desired impact. The methods used to analyze data in quality improvement differ slightly from those used in classical statistics. Run charts and statistical process control charts are the most common types of graphical representations used to visualize data collected for quality improvement. This review provides a basic introduction to measurement in quality improvement and explains the use of run ch...
Source: Paediatric Anaesthesia - February 20, 2021 Category: Anesthesiology Authors: Heather A Wolfe April Taylor Rajeev Subramanyam Source Type: research

Best Abstracts for APA Online meeting 2020.
Authors: PMID: 33608935 [PubMed] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - February 20, 2021 Category: Anesthesiology Tags: Paediatr Anaesth Source Type: research

Statistics in Quality Improvement: Measurement and Statistical Process Control.
Abstract Data are used in healthcare quality improvement endeavors to measure and determine if the changes made in the course of the work have made the desired impact. The methods used to analyze data in quality improvement differ slightly from those used in classical statistics. Run charts and statistical process control charts are the most common types of graphical representations used to visualize data collected for quality improvement. This review provides a basic introduction to measurement in quality improvement and explains the use of run charts and statistical process control charts with real life examples...
Source: Paediatric Anaesthesia - February 20, 2021 Category: Anesthesiology Authors: Wolfe HA, Taylor A, Subramanyam R Tags: Paediatr Anaesth Source Type: research

Effect of the prone position and head-down tilt on intra-abdominal pressure and on cerebral and splanchnic oxygenation in infants undergoing Posterior Sagittal AnoRectoPlasty for anorectal malformations.
This study aimed to evaluate, in infants undergoing PSARP, the effect of positioning (prone ± head-down tilt) on intra-abdominal pressure and on cerebral (CrSO2), renal (RrSO2) and mesenteric (MrSO2) regional oxygenation measured by NIRS. PMID: 33606337 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - February 19, 2021 Category: Anesthesiology Authors: Franzini S, Morandi A, Consonni D, Calderini E, Leva E Tags: Paediatr Anaesth Source Type: research

Regional Anesthesia in Pediatric Patients with Preexisting Neurological Disease.
Abstract Preexisting neurological disease in pediatric patients presents unique challenges to the anesthesiologist. In-depth knowledge of the disease processes and awareness of sequalae that uniquely influence the risks and benefits of anesthetics are needed to make informed decisions. Because these vulnerable populations are often susceptible to perioperative airway or cardiopulmonary complications, the use of regional anesthesia can be advantageous. However, these clinical conditions already involve compromised neural tissue, and as such, creates additional concern that regional anesthesia may result in new or w...
Source: Paediatric Anaesthesia - February 16, 2021 Category: Anesthesiology Authors: Cung S, Ritz ML, Masaracchia MM Tags: Paediatr Anaesth Source Type: research

Rapid and safe removal of foreign bodies in the upper esophagus in children using an optimized Miller size 3 video laryngoscope blade - a prospective observational trial.
CONCLUSION: The new Miller size 3 video laryngoscope enables rapid, easy, and reliable extraction of foreign bodies when they are located in the upper part of the esophagus. As early removal of esophageal foreign bodies, especially with button batteries prevents life-threatening complications, we suggest this technique as the first choice of treatment. PMID: 33583069 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - February 14, 2021 Category: Anesthesiology Authors: Kaufmann J, Grozeva B, Laschat M, Brackhahn M, Rudolph D, Neuhaus N, Hubertus J, Wappler F, Eich C Tags: Paediatr Anaesth Source Type: research

An unexpected Covid-19 diagnosis during emergency surgery in a neonate.
This report highlights a neonate with an incidental positive SARS-CoV-2 test, no known exposure history, negative polymerase chain reaction maternal testing, and absence of respiratory symptoms who required modified pressure control ventilation settings to adequately ventilate with the high-efficiency particulate air filter in situ. PMID: 33570775 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - February 11, 2021 Category: Anesthesiology Authors: Moreno-Duarte I, Evans AS, Alder AC, Vernon MC, Szmuk P, Rebstock S Tags: Paediatr Anaesth Source Type: research

Primary spread of caudal blockade in children: the possible limiting role of the lumbar spinal cord enlargement (tumenescence) in combination with the cerebrospinal fluid rebound mechanism.
CONCLUSION: The maximum of the lumbar spinal enlargement is located at the Th 11 vertebral level. Although not entirely conclusive, the findings of the present study do support the notion that the lumbar spinal enlargement, in combination with the CSF rebound mechanism, may be the factors limiting the initial spread of a caudal block to the thoraco-lumbar junction. PMID: 33567110 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - February 10, 2021 Category: Anesthesiology Authors: Castillo P, Forestier J, Wiegele M, Finnbogasson T, Lönnqvist PA Tags: Paediatr Anaesth Source Type: research

An approach to define newborns' sniffing position using an angle based on reproducible facial landmarks.
CONCLUSIONS: This study provides a new measuring technique using an angle that is reproducible and reliable and may be used in future studies to correlate head position with airway obstruction. PMID: 33555071 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - February 8, 2021 Category: Anesthesiology Authors: Haase B, Badinska AM, Poets CF, Koos B, Springer L Tags: Paediatr Anaesth Source Type: research

The Impact of Surgical Cancellations on Children, Families, and the Health System in an Australian Paediatric Tertiary Referral Hospital.
Abstract BACKGROUND: Reasons for elective surgery cancellations and their impact vary from one institution to another. Cancellations have emotional and financial implications for patients and their families. Our service has a particularly broad and geographically diverse patient population, hence we sought to examine these impacts in our service. METHODS: We identified families with procedural cancellations and administered a telephone questionnaire. Survey items included the reason for and timing of cancellation, how the family was informed, the mode of transport and distance travelled to the hospital, assoc...
Source: Paediatric Anaesthesia - February 8, 2021 Category: Anesthesiology Authors: Drake-Brockman TF, Chambers NA, Sommerfield D, von Ungern-Sternberg BS Tags: Paediatr Anaesth Source Type: research

Implications of anesthesia and vaccination.
Abstract The current COVID-19 pandemic has had a global impact on vaccination rates. Delays in routine healthcare and immunization have led to a rise in concerns about resurgence of vaccine-preventable diseases around the world. With the release and distribution of COVID-19 vaccines, plans to improve immunization rates need to be explored and implemented across disciplines. One approach would be the consideration of perioperative vaccinations; however, the effects of anesthesia and surgery on the immune response and complications associated with vaccination during the perioperative period are still poorly understo...
Source: Paediatric Anaesthesia - February 4, 2021 Category: Anesthesiology Authors: Lin C, Vazquez-Colon C, Geng-Ramos G, Challa C Tags: Paediatr Anaesth Source Type: research

Cerebral autoregulation in infants during Sevoflurane anesthesia for craniofacial surgery.
yr L Abstract BACKGROUND: Data on cerebral pressure-flow autoregulation in the youngest children are scarce. We studied the correlation between mean arterial pressure and cerebral tissue oxygen saturation (rSO2 ) by near-infrared spectroscopy (NIRS) in patients undergoing nose, lip and palate (NLP) surgery. AIM: We tested the hypothesis that cerebral pressure-flow autoregulation is impaired in children less than 1 year undergoing surgery and general anesthesia with sevoflurane under controlled mechanical ventilation. METHOD: After approval from the Ethical board, 15 children aged
Source: Paediatric Anaesthesia - February 2, 2021 Category: Anesthesiology Authors: Jildenstål P, Widarsson Norbeck D, Snygg J, Ricksten SE, Lannemyr L Tags: Paediatr Anaesth Source Type: research

Food Allergy History and Reaction to Propofol Administration in a Large Pediatric Population.
CONCLUSIONS: In the listed food-allergic cohort, the majority had no allergy testing or negative testing. We found no evidence of a relationship between food allergy history and perioperative propofol reaction. We suggest multiply allergic and atopic patients may have a similar likelihood of propofol reaction as with other medications. PMID: 33529424 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - February 2, 2021 Category: Anesthesiology Authors: Bagley L, Kordun A, Sinnott S, Lobo K, Cravero J Tags: Paediatr Anaesth Source Type: research

Observance of preoperative clear fluid fasting in paediatric anaesthesia: oral and written information versus text message information. A before-and-after study.
Abstract INTRODUCTION: Prolonged fasting before surgery is common in paediatrics. In the literature, it is responsible for hypotension, irritability and post-operative nausea and vomiting. Despite clear instructions given during the preanesthetic consultation, fasting rules are respected in only 30% to 40% of cases. We aimed to evaluate the benefit of sending a text message the day before surgery to improve the parents observance to of fasting rules. METHODS: We conducted a before-and-after study at the University Hospital of Poitiers. From August to October 2018, 172 parents of children under 15 years of age...
Source: Paediatric Anaesthesia - February 1, 2021 Category: Anesthesiology Authors: Thomasseau A, Rebollar Y, Dupuis M, Marschal N, Mcheik J, Debaene B, Frasca D, Boisson M Tags: Paediatr Anaesth Source Type: research

Tracheal Intubation related adverse Events in Pediatrics Anesthesia in Ethiopia.
CONCLUSION AND RECOMMENDATIONS: The incidence of tracheal intubation related adverse events in pediatric surgical patients is high. Anesthesia professionals should be vigilant and have a pre-planned strategy to avoid intubation related adverse events ,especially in high-risk patients. The use of difficult airway algorithms, oxygen saturation monitoring and training in simulation room are very important strategies to help reduce patient harm. PMID: 33506587 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 28, 2021 Category: Anesthesiology Authors: Tamire T, Garbessa B, Gebeyu G, Getachew L Tags: Paediatr Anaesth Source Type: research

Race and major post-operative pulmonary complications following elective inpatient pediatric otolaryngology surgery.
Abstract BACKGROUND: Compared to their white peers, black children are more likely to experience serious respiratory complications in the perioperative period. Whether a racial difference exists in the occurrence of late postoperative respiratory complications is largely unknown. Here, we evaluated a multi-institutional cohort of children who underwent various elective otolaryngology procedures to examine the racial differences in major post-operative pulmonary complications. METHODS: We performed a retrospective analysis of elective inpatient otolaryngology cases from the National Surgical Quality Improvemen...
Source: Paediatric Anaesthesia - January 27, 2021 Category: Anesthesiology Authors: Sivak E, Mpody C, Willer BL, Tobias J, Nafiu OO Tags: Paediatr Anaesth Source Type: research

An assessment of perioperative respiratory adverse events and difficult intubation in pediatric patients with trisomy 21.
CONCLUSIONS: Compared to matched controls, children with trisomy 21 have a lower incidence of difficult intubation and a higher incidence of perioperative respiratory adverse events, largely due to increased rate of airway obstruction. PMID: 33484030 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 23, 2021 Category: Anesthesiology Authors: Graber T, Baskin P, Soria C, Greenberg M, Gabriel R, Brzenski A Tags: Paediatr Anaesth Source Type: research

Peri-operative pediatric tonsillectomy analgesia. A single centre review of practice and cost effectiveness analysis.
Abstract Tonsillectomy is one of the most common pediatric surgeries and results in considerable post-operative pain.1 Insufficiently controlled pain is costly, risks physiological and psychological consequences with multi-modal analgesia widely recommended to minimize opioid based agents.1 2 We determined adherence to multi-modal analgesia guidelines and assessed cost effectiveness. PMID: 33484060 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 23, 2021 Category: Anesthesiology Authors: Hii J, von Ungern-Sternberg BS, Sommerfield A, Sommerfield D Tags: Paediatr Anaesth Source Type: research

Hands-Free Continuous Transthoracic Echocardiography: a Contemporary Evolution of the Precordial Stethoscope.
Abstract Point of care ultrasonography (POCUS) is a rapidly evolving diagnostic modality. Equipment to scan various parts of the body with compact handheld devices is readily available. Surface cardiac ultrasound (US) can be used to rapidly assess volume status, cardiac function, and the detection of pericardial fluid. In the case presented here, we describe the use of a novel, hands-free, biplane, transthoracic echocardiography (TTE) probe with a design that provided continuous acquisition of cardiac US images during an operative procedure. PMID: 33482049 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 22, 2021 Category: Anesthesiology Authors: Alrayashi W, Kelleher S, DiNardo J, Kovatsis P, Clarke W, Hickey P, Park R Tags: Paediatr Anaesth Source Type: research

Feasibility of Effectiveness Trials in Pediatric Anesthesia.
Abstract Effectiveness studies aim to investigate whether an intervention does more good than harm in normal clinical practice. Cochrane´s hierarchy of evidence incorporating efficacy, effectiveness and cost-effectiveness research provides a useful framework to assess whether interventions are efficacious and effective. The philosophy of science model of disease, illness, and sickness can be used to identify issues in pediatric anesthetic research and constructively maps onto Cochrane´s hierarchy. Historically research in pediatric anesthesia has concentrated on efficacy studies, which even if of excel...
Source: Paediatric Anaesthesia - January 12, 2021 Category: Anesthesiology Authors: Morton WJ Tags: Paediatr Anaesth Source Type: research

A comparison of cannula insufflation device performance for emergency front of neck airway.
Abstract BACKGROUND: Pediatric emergency front of neck airway guidelines recommend oxygenation via cannula cricothyroidotomy or tracheotomy. AIM: The primary aim was to measure test lung pressures and volumes generated by cannula insufflation devices recommended for emergency front of neck airway compared with a pressure limit of 50 cm H2 O and volume limit of 20 ml/kg. The secondary aim was to calculate pressure and volume variability. The primary end point was test-lung expansion. METHOD: Adult, child and infant airway models, each with three degrees of upper airway obstruction, were oxygenated using s...
Source: Paediatric Anaesthesia - January 11, 2021 Category: Anesthesiology Authors: Mann CM, Baker PA, Sainsbury DM, Taylor R Tags: Paediatr Anaesth Source Type: research

Perioperative hypersensitivity reactions during childhood and outcomes of subsequent anesthesia.
CONCLUSION: Data on perioperative hypersensitivity reactions during childhood is rare due to limited diagnostic procedures. Different preference of general anesthetics may change the causative agent. Meticulous evaluation is necessary to safely administer subsequent anesthesia. PMID: 33423333 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 10, 2021 Category: Anesthesiology Authors: Karaatmaca B, Sahiner UM, Sekerel BE, Soyer O Tags: Paediatr Anaesth Source Type: research

We still can't hear: Staff Perceptions of Personal Protective Equipment Impact on Speech and Communication In the Operating Theatre During Paediatric Airway Surgery.
Abstract We wish to highlight the continued impact of personal protective equipment (PPE) (filtering facemask and powered respirators) as a barrier to communication when used during aerosol generating procedures such as pediatric airway surgery in the operating theatre during the endemic phase of coronavirus disease 2019 (COVID-19) and present our multi-cadre staff survey to emphasize an ongoing potential patient safety issue inherent to current guidance. PMID: 33423347 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 10, 2021 Category: Anesthesiology Authors: Hampton T, Sharma S, Dunham M, Okonkwo I Tags: Paediatr Anaesth Source Type: research

Dose Estimation for Bivalirudin during Pediatric Cardiopulmonary Bypass.
CONCLUSION: Bivalirudin infusion in children should be started after loading dose at rates greater than those used in adults. Dose in neonates remains uncertain because neither pharmacokinetics nor coagulation pharmacodynamics have been adequately characterized. PMID: 33423355 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 10, 2021 Category: Anesthesiology Authors: Wolstencroft P, Arnold P, Anderson BJ Tags: Paediatr Anaesth Source Type: research

An observational study of hypoactive delirium in the post-anesthesia recovery unit of a pediatric hospital.
CONCLUSION: The significance of hypoactive delirium in this population is unknown, however previous studies have shown that emergence delirium can result in post-operative behaviour changes and may affect compliance with future episodes of care. However, hypoactive delirium is often missed without active screening. The prevalence detected in this study therefore suggests hypoactive delirium warrants further investigation. PMID: 33405250 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 6, 2021 Category: Anesthesiology Authors: Lee-Archer PF, von Ungern-Sternberg BS, Reade MC, Law KC, Long D Tags: Paediatr Anaesth Source Type: research

Inflation volume - balloon diameter and inflation pressure - balloon diameter characteristics of commonly used bronchial blocker balloons for single-lung ventilation in children.
CONCLUSION: Based on these study findings, the balloons of Fogarty arterial embolectomy catheters represent high pressure devices and do not permit stepwise controlled bronchial blockage. The Arndt endobronchial blockers have some advantages over the Fogarty blocker devices, but also represent high pressure equipment and must be used with caution and limited duration. Manufacturers are asked to design pediatric endobronchial blocker catheters with truly high-volume, low-pressure balloons in accordance to age-related pediatric airway dimensions. PMID: 33406307 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 6, 2021 Category: Anesthesiology Authors: Goetschi M, Kemper M, Kleine-Brueggeney M, Dave MH, Weiss M Tags: Paediatr Anaesth Source Type: research

Error Traps in Anesthesia for Fetal Interventions.
This article focuses on promoting a culture of safety by highlighting five common error traps while anesthetizing patients for fetal interventions. They include failure to preserve uteroplacental perfusion and gas exchange, failure to achieve adequate uterine relaxation prior to hysterotomy, failure to monitor the fetus and prepare for fetal/neonatal resuscitation, failure to prepare for maternal hemorrhage, and failure to promptly treat uterine atony. Practical tips for avoiding these serious complications will also be discussed. PMID: 33394561 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 4, 2021 Category: Anesthesiology Authors: Ferschl MB, Rollins MD, Chatterjee D Tags: Paediatr Anaesth Source Type: research

"You can't make me!" Managing adolescent dissent to anesthesia.
"You can't make me!" Managing adolescent dissent to anesthesia. Paediatr Anaesth. 2021 Jan 01;: Authors: Bryant BE, Adler AC, Mann DG, Malek J Abstract When adolescents require healthcare, the need to obtain consent from the parent/legal guardian and assent from the patient can create the potential for an ethical dilemma when these two parties are not in agreement. Here we describe a representative and common case scenario in which both parent and adolescent patient gave consent and assent, respectively, with a full understanding of the risks and benefits of the procedure and anesthetic. At ...
Source: Paediatric Anaesthesia - January 1, 2021 Category: Anesthesiology Authors: Bryant BE, Adler AC, Mann DG, Malek J Tags: Paediatr Anaesth Source Type: research

Well-being of the global anesthesiologist.
PMID: 33378131 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 31, 2020 Category: Anesthesiology Authors: Gray RM, Evans FM Tags: Paediatr Anaesth Source Type: research

The difficult colleague: About disruptive behaviors and narcissistic personalities.
PMID: 33378132 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 31, 2020 Category: Anesthesiology Authors: Veyckemans F Tags: Paediatr Anaesth Source Type: research

A sense of belonging.
PMID: 33378133 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 31, 2020 Category: Anesthesiology Authors: Diaz-Berenstain LK Tags: Paediatr Anaesth Source Type: research

Rising up: A most disruptive opportunity.
PMID: 33378135 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 31, 2020 Category: Anesthesiology Authors: Black SA Tags: Paediatr Anaesth Source Type: research

Burnout recognition and mitigation in the context of a global pandemic.
PMID: 33378136 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 31, 2020 Category: Anesthesiology Authors: Kaur B Tags: Paediatr Anaesth Source Type: research

Anesthesia for Pediatric Patients with Anti-NMDA-Receptor Encephalitis: a retrospective case series.
The objective of this case series is to examine how anesthesia affects pediatric patients with this disease. METHODS: We performed a retrospective chart review of 28 records in 17 patients who underwent anesthesia. Our primary outcomes were hemodynamic changes during the perioperative period. Heart rate, systolic and diastolic blood pressures, respiratory rate, and oxygen saturation comprise our end-points. A subgroup of patients, who underwent imaging with anesthesia, was then compared to controls. RESULTS: In anti-N-methyl-D-aspartate-receptor encephalitis cases, there were significant percent changes from base...
Source: Paediatric Anaesthesia - December 28, 2020 Category: Anesthesiology Authors: Bell M, Friedman M, Matar M, Sakmar S, Wee CP, Ross P, Nagoshi M Tags: Paediatr Anaesth Source Type: research

Epidural versus general anesthesia for open pyloromyotomy in infants: a retrospective observational study.
CONCLUSIONS: In our series, maintaining spontaneous breathing with minimal airway manipulation in patients undergoing open repair of hypertrophic pyloric stenosis under single-shot epidural anesthesia resulted in fewer desaturation events ≤90% than general anesthesia. In addition, this approach seems to result in shorter turnover times in the operating room. PMID: 33368903 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 25, 2020 Category: Anesthesiology Authors: Opfermann P, Wiener C, Schmid W, Zadrazil M, Metzelder M, Kimberger O, Marhofer P Tags: Paediatr Anaesth Source Type: research

The use of Lean Methodology to reduce personal protective equipment wastage in children undergoing congenital cardiac surgery, during the COVID-19 pandemic.
CONCLUSION: The use of Lean methodology can reduce waste of PPE and plastic, resulting in cost savings, while reducing staff exposure when testing patients with congenital cardiac disease for SARS-CoV-2. By preventing admission of SARS-CoV-2-positive patients, we can reduce use of isolation beds and prevent cancellation of surgery, improving patient flow and departmental efficiency. Other departments in our institution are implementing similar admission pathways to allow surgical services to restart during the ongoing pandemic. PMID: 33345391 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 20, 2020 Category: Anesthesiology Authors: Sheehan JR, Lyons B, Holt F Tags: Paediatr Anaesth Source Type: research

The Impact of the COVID-19 Pandemic on the Education and Wellness of U.S. Pediatric Anesthesiology Fellows.
Abstract The global coronavirus disease 2019 (COVID-19) pandemic caused statewide shutdowns of elective surgical activities in March and April of 2020 forcing graduate medical education program directors and their trainees in the United States to quickly adapt to new rules and circumstances. The aim of this study was to determine the effect of the current pandemic on pediatric anesthesiology fellow education and wellness nationally in order to guide creation of optimal support systems for fellows during the ongoing pandemic. A total of 75 out of 184 pediatric anesthesiology fellows (41%) responded to the survey. M...
Source: Paediatric Anaesthesia - December 20, 2020 Category: Anesthesiology Authors: Shih G, Deer JD, Lau J, Loveland Baptist L, Lim DJ, Lockman JL Tags: Paediatr Anaesth Source Type: research

The Impact of Tumor Excision on American Society of Anesthesiology Physical Status Scoring Among Pediatric Anesthesiologists: A Retrospective Review.
Abstract An American Society of Anesthesiology-Physical Status (ASA-PS) score is assigned topatients prior to undergoing anesthesia as a means of quantifying the impact of a patient's comorbidities. While this is the most common use, ASA-PS scores are also usedinclinical research and to determinefinancial reimbursement for anesthesia services. PMID: 33340168 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 19, 2020 Category: Anesthesiology Authors: Ly EI, Brennan RC, Wilson MW, Sahr N, Sykes A, Morgan KJ Tags: Paediatr Anaesth Source Type: research

Comparative Evaluation of One-handed Versus Two-handed Mask Holding Techniques in Children During Inhalational Induction of Anesthesia: A Randomized Crossover Study.
Abstract BACKGROUND: We aimed to evaluate if two-handed mask airway is superior to one-handedmask airway during inhalational induction of anesthesiain children. METHODS: A randomized, two period, crossover study was performed on 60 children aged 1 to 8 years, with obstructive sleep apnea due to adenotonsillar hypertrophy, scheduled for adenotonsillectomy. Children were assigned to two study sequences and one control sequence of 20 subjects each. A control sequence was added to evaluate the effect of anesthetic depth. Sequence 1: One-handed followed by two-handed airway, 30 seconds each; Sequence 2: two-handed...
Source: Paediatric Anaesthesia - December 19, 2020 Category: Anesthesiology Authors: Choudhry DK, Brenn BR, Sacks K, Lutwin-Kawalec M, Aaronson NL, Rahman T Tags: Paediatr Anaesth Source Type: research

Optimal insertion depth of subclavian vein catheterization via the right supraclavicular approach in children.
Abstract BACKGROUND: Methods to determine the optimal insertion depth of ultrasound-guided supraclavicular approach to the subclavian vein (SCV) catheterization, alternatively used for central venous access, are debatable in children. AIM: We investigated the applicability and reliability of the modified formula for determining the depth of SCV catheterization using an ultrasound-guided supraclavicular approach in children. METHODS: This prospective observational study included 36 children (age
Source: Paediatric Anaesthesia - December 17, 2020 Category: Anesthesiology Authors: Ye P, Tan Y, Shi S, Liu L Tags: Paediatr Anaesth Source Type: research

Hypotension and Adverse Neurodevelopmental Outcomes among Children with Multiple Exposures to General Anesthesia: Sub-analysis of the Mayo Anesthesia Safety in Kids (MASK) Study.
Abstract BACKGROUND: The potential adverse effects of exposures to general anesthesia on the developing human brain remain controversial.It has been hypothesized that hypotension accompanying anesthesia could be contributory. We hypothesized that among children exposed to multiple anesthetics prior to age 3, children developing adverse neurodevelopmental outcomes would be more likely to have intraoperative hypotension. METHODS: Two previously published study cohorts were utilized for analysis: the retrospective and prospective Mayo Anesthesia Safety in Kidscohorts.The two lowest consecutivesystolic blood pres...
Source: Paediatric Anaesthesia - December 15, 2020 Category: Anesthesiology Authors: Gleich SJ, Shi Y, Flick R, Zaccariello MJ, Schroeder DR, Hanson AC, Warner DO Tags: Paediatr Anaesth Source Type: research

Anesthesia Management for ENT surgery in a Child with X-linked Pyruvate Kinase Deficiency.
Abstract Pyruvate dehydrogenase complex deficiency (PDCD) is a rare x-linked disorder that affects glucose metabolism. There are several case reports describing the anesthetic management of patients with PDCD. This is the first case report to describe the anesthetic management of a PDCD patient requiring spontaneous ventilation using dexmedetomidine and ketamine. PMID: 33295086 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 8, 2020 Category: Anesthesiology Authors: Hau V, Bonilla-Velez J, Low D Tags: Paediatr Anaesth Source Type: research

A comparison of anesthetic protective barriers for the management of COVID-19 pediatric patients.
CONCLUSIONS: A well-designed intubation box is an effective barrier against droplets and is non-inferior to no barrier in relation to intubation time.However, a box interferes with laminar flow in theatres with formal ventilation systems and may result in accumulation of aerosols if it is completely enclosed. PMID: 33280199 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 6, 2020 Category: Anesthesiology Authors: Lee-Archer P, Boyd D, Du T, Elliott R, Graydon C, Paterson N, Morawska L Tags: Paediatr Anaesth Source Type: research

Perioperative Anxiety in Pediatric Surgery: Induction Room vs. Operating Room.
CONCLUSIONS: The non-pharmacological strategy of using an induction room for anesthetic induction of children may be clinically effective in reducing anxiety as compared to an operating room. PMID: 33278852 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 5, 2020 Category: Anesthesiology Authors: Wingler D, Liston D, Joseph A, Wang Y, Feng H, Martin L Tags: Paediatr Anaesth Source Type: research

Antinociceptive Effect of Vapocoolant Medium Stream Spray onHotplate LatencyinRat Pups.
Abstract BACKGROUND: Heel sticks account formostblood tests performed in neonateswithout analgesia because topical localanestheticsare ineffective on heelglabrous skin. We investigated the antinociceptive effect of an alternative topical analgesic, avapocoolant spray, on hindpaws glabrous skin of rat pups. The spray was applied by two methods: method-1 for 4 seconds at a distance of 8 cm and method-2 for 10 seconds at a distance of 18 cm. METHODS: The rat pups were randomized to either method-1 (n = 32) or method-2 (n = 31). Vapocoolant spray was applied to one hind paw randomly and saline spray was applied t...
Source: Paediatric Anaesthesia - December 3, 2020 Category: Anesthesiology Authors: Sethna NF, Fish B, Yahalom B, Schmidt B, Zurakowski D Tags: Paediatr Anaesth Source Type: research

The utility of ultrasonography in anesthesia management in 3 cases of caudal regression. Syndrome.
We report three cases where optimal use of ultrasonography aided in providing satisfactory peri- operative pain relief. Furthermore, a cogent and a logical review of the decision-making processes for the regional blockade in children with caudal regression syndrome are presented. PMID: 33269503 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - December 2, 2020 Category: Anesthesiology Authors: Ponde VC, Desai AP, Puranik KA, Bosenberg A, Chavan DN Tags: Paediatr Anaesth Source Type: research

Pediatric acute compartment syndrome due to surgical positioning: a case report.
We present a case of compartment syndrome after a non-orthopedic surgery. PMID: 33251709 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - November 30, 2020 Category: Anesthesiology Authors: Teng HC, Arslan-Carlon V, Teng HC Tags: Paediatr Anaesth Source Type: research