Mispositioning the end of a cuff inflating line in long ‐axis ultrasound imaging of the pediatric larynx and trachea
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 11, 2017 Category: Anesthesiology Authors: Kenji Kayashima, Keiko Imai Tags: CORRESPONDENCE Source Type: research

Continuous Erector Spinae Plane block for thoracic surgery in a pediatric patient
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 11, 2017 Category: Anesthesiology Authors: Juan Carlos De la Cuadra ‐Fontaine, Mario Concha, Fernando Vuletin, Hernán Arancibia Tags: CORRESPONDENCE Source Type: research

In response to “Interventions designed using quality improvement methods reduce the incidence of serious airway events and airway cardiac arrests during pediatric anesthesia”
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 11, 2017 Category: Anesthesiology Authors: Benjamin H. Cloyd Tags: CORRESPONDENCE Source Type: research

We need personalized assessments for implicit bias in higher risk situations
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 11, 2017 Category: Anesthesiology Authors: David B. Waisel Tags: EDITORIAL Source Type: research

What can we learn (or not) from in  vitro airway studies for clinical applications in children?
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 11, 2017 Category: Anesthesiology Authors: Narasimhan Jagannathan, Britta S. Ungern ‐Sternberg Tags: EDITORIAL Source Type: research

In this issue: January 2018
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 11, 2017 Category: Anesthesiology Authors: Andrew Davidson Tags: IN THIS ISSUE Source Type: research

Issue Information
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 11, 2017 Category: Anesthesiology Tags: ISSUE INFORMATION Source Type: research

Cerebrovascular blood pressure autoregulation monitoring and postoperative transient ischemic attack in pediatric moyamoya vasculopathy
ConclusionDysfunctional intraoperative autoregulation may increase the risk of TIA in patients with pediatric moyamoya vasculopathy. The blood pressure range that supports autoregulation appears to vary among patients. Using autoregulation monitoring to guide individualized blood pressure goals should be studied as a potential method to reduce perioperative neurologic morbidity in pediatric patients with moyamoya. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 5, 2017 Category: Anesthesiology Authors: Jennifer K. Lee, Monica Williams, Michael Reyes, Edward S. Ahn Tags: RESEARCH REPORT Source Type: research

Prospective analysis of serious cardiorespiratory events in children during ophthalmic artery chemotherapy for retinoblastoma under a deep standardized anesthesia
ConclusionSerious cardiorespiratory events occur commonly during super selective ophthalmic artery chemotherapy. Standardized deep anesthesia with analgesia did not appear to be protective. No predictive factors were identified, but these events systematically arose within 2 minutes after ophthalmic artery catheter insertion. Anesthetists and neuroradiologists should be prepared to manage these serious complications and parents should be informed of the risks. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 5, 2017 Category: Anesthesiology Authors: Marie ‐Claire Nghe, Anne Godier, Anoushée Shaffii, Isabelle Leblanc, Hervé Picard, Raphaël Blanc, Livia Lumbroso‐Le Rouic, Jean‐Michel Devys Tags: RESEARCH REPORT Source Type: research

Ultrasound ‐guided pudendal nerve block in children: A new technique of ultrasound‐guided transperineal approach
ConclusionThe new technique of ultrasound‐guided pudendal nerve block, described in this study, seems to be easy to perform with a good success rate, and probably improves safety of the puncture and of the injection by real‐time visualization of anatomical structures and local anesthetic spread. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 5, 2017 Category: Anesthesiology Authors: Isabelle Gaudet ‐Ferrand, Pablo De La Arena, Sophie Bringuier, Olivier Raux, Laurent Hertz, Nicolas Kalfa, Chrystelle Sola, Christophe Dadure Tags: RESEARCH REPORT Source Type: research

Ultrasound ‐guided lower forearm median nerve block in open surgery for trigger thumb in 1‐ to 3‐year‐old children: A randomized trial
ConclusionUltrasound‐guided lower forearm median nerve block can provide more effective analgesia, a higher success rate, and lower general and local anesthetic dosages than the anatomic landmark‐based blocking method in children undergoing open surgery for trigger thumb. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - December 5, 2017 Category: Anesthesiology Authors: Wei Liu, Jianxia Liu, Xingqin Tan, Shouyong Wang Tags: RESEARCH REPORT Source Type: research

Perioperative management of gastrostomy tube placement in Duchenne muscular dystrophy adolescent and young adult patients: A role for a perioperative surgical home
Summary BackgroundIn past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AimsThe aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by va...
Source: Pediatric Anesthesia - December 1, 2017 Category: Anesthesiology Authors: Ariane Boivin, Richard Antonelli, Navil F. Sethna Tags: RESEARCH REPORT Source Type: research

Introducing the 6 ‐4‐0 fasting regimen and the incidence of prolonged preoperative fasting in children
ConclusionThe introduction and implementation of the 6‐4‐0 fasting regimen reduces median fluid fasting duration and the number of children subjected to extended fasting. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 23, 2017 Category: Anesthesiology Authors: Hanna Andersson, Per M. Hellstr öm, Peter Frykholm Tags: RESEARCH REPORT Source Type: research

Assessment of sedation level prior to neonatal intubation: A  systematic review
ConclusionNo validated scoring systems to assess the level of sedation prior to intubation in newborns are available in the literature. Three objective sedation assessment tools seem promising but need further validation before they can be implemented in research and clinical settings. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 21, 2017 Category: Anesthesiology Authors: Ellen H. M. Kort, Nienke M. Halbmeijer, Irwin K. M. Reiss, Sinno H. P. Simons Tags: SYSTEMATIC REVIEW Source Type: research

Incidence and predictors of 30 ‐day postoperative readmission in children
ConclusionChildren with congenital heart disease, high American Society of Anesthesiologist physical class, inpatient status, and at least 1 postoperative complication of any kind are at high risk for postsurgical readmissions. We provide an algorithm for quantifying this risk with the goal of reducing the number of readmissions, improving the care of patients with complex chronic illnesses, and reducing hospital costs. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 20, 2017 Category: Anesthesiology Authors: Daniel Vo, David Zurakowski, David Faraoni Tags: RESEARCH REPORT Source Type: research

Pressure ‐flow characteristics of breathing systems and their components for pediatric and adult patients
Summary BackgroundBreathing circuits connect the ventilator to the patients’ respiratory system. Breathing tubes, connectors, and sensors contribute to artificial airway resistance to a varying extent. We hypothesized that the flow‐dependent resistance is higher in pediatric breathing systems and their components compared to respective types for adults. AimsWe aimed to characterize the resistance of representative breathing systems and their components used in pediatric patients (including devices for adults) by their nonlinear pressure‐flow relationship. MethodsWe used a physical model to measure the flow‐depe...
Source: Pediatric Anesthesia - November 17, 2017 Category: Anesthesiology Authors: Christin Wenzel, Stefan Schumann, Johannes Spaeth Tags: RESEARCH REPORT Source Type: research

Donohue syndrome: A review of literature, case series, and anesthetic considerations
We report a case series of 5 patients with Donohue syndrome who have presented to our institution. This small series of children with this complex disorder demonstrates a clearly increased risk of general anesthesia. Many of the risks relate to restrictive lung disease and abdominal distension which worsens with bag valve mask ventilation and limited respiratory reserve which leads to precipitous desaturation. During induction, a spontaneously breathing technique is recommended. If required, bag valve mask ventilation should be accompanied by constant gastric aspiration. Intubation is challenging, and a difficult airway pl...
Source: Pediatric Anesthesia - November 17, 2017 Category: Anesthesiology Authors: Alana Kirkwood, Grant Stuart, Louise Harding Tags: SYSTEMATIC REVIEW Source Type: research

The anatomy of the pediatric airway: Has our knowledge changed in 120 years? A review of historic and recent investigations of the anatomy of the pediatric larynx
ConclusionIn vivo studies do not take into account the motion of the highly pliable laryngeal upper airway structures (aryepiglottic, vestibular, and vocal folds). Maximal abduction of these structures with tracheal tubes or bronchoscopes always demonstrates a larger opening of the glottis compared to the outlet of the cricoid ring. Injury to the larynx depends upon ease of tracheal tube or endoscope passage past the cricoid cartilage and not passage through the readily distensible more proximal structures. The infant larynx is funnel shaped with the narrowest portion the circular or near circular cricoid cartilage confirm...
Source: Pediatric Anesthesia - November 17, 2017 Category: Anesthesiology Authors: Josef Holzki, Karen A. Brown, Robert G. Carroll, Charles J. Cot é Tags: SYSTEMATIC REVIEW Source Type: research

Clinical implications of de Barsy syndrome
ConclusionThis expanded case series suggests that providers caring for patients with de Barsy syndrome should be aware of potential challenges with airway management, vascular access, and temperature monitoring. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 17, 2017 Category: Anesthesiology Authors: Lindsay L. Warner, David A. Olsen, Hugh M. Smith Tags: RESEARCH REPORT Source Type: research

Nitroglycerin: An unusual solution to intraoperative hypothermia in a 4 ‐year‐old burn patient
We describe the case of a 4‐year‐old child undergoing extensive burn surgery with refractory intraoperative hypothermia. A low‐dose nitroglycerin infusion was initiated to reverse vasoconstriction and improve heat absorption, after which the child's temperature steadily improved. In hypothermic burn patients, topical vasoconstrictors may hinder surface warming efforts. A vasodilator infusion may aid in warming the pediatric patient undergoing extensive excision and grafting. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 17, 2017 Category: Anesthesiology Authors: Eduardo J. Goenaga D íaz, Jeffrey E. Carter, T. Wesley Templeton Tags: CASE REPORT Source Type: research

New solutions to reduce wrong route medication errors
Summary Wrong route medication errors due to tubing misconnections are potentially life‐threatening complications that have been made possible by the universal use of the Luer connector. The new International Organization of Standardization standards for small bore connectors, ISO 80369 series, have been developed to reduce the risk of these types of erroneous connections. Tubing connectors for different routes of clinical application will contain differently designed connectors that are physically incompatible. However, design and manufacturing standards have progressed slowly, and clinical roll‐outs have been delayed...
Source: Pediatric Anesthesia - November 17, 2017 Category: Anesthesiology Authors: Ronald S. Litman, Victoria I. Smith, Phoebe Mainland Tags: EDUCATIONAL REVIEW Source Type: research

Issue Information
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 7, 2017 Category: Anesthesiology Tags: ISSUE INFORMATION Source Type: research

Reviewers List
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 6, 2017 Category: Anesthesiology Tags: REVIEWERS LIST Source Type: research

Infant spinal anesthesia: Do girls need a larger dose of local anesthetic?
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 6, 2017 Category: Anesthesiology Authors: Geoff Frawley, Md Hamidul Huque Tags: CORRIGENDUM Source Type: research

Reply to Adam Adler and Arvind Chandrakantan regarding their comment “Nursing initiated tracheal extubation in PACU, the risk of delegating critical anesthesiology tasks in the interest of speed”
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 6, 2017 Category: Anesthesiology Authors: Hiromi Kako, Marco Corridore, Dmitry Tumin, Joseph D. Tobias Tags: CORRESPONDENCE Source Type: research

Comment on: “Gálvez et al.: Interactive pediatric emergency checklists to the palm of your hand ‐ How the pedi crisis app traveled around the world”
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 6, 2017 Category: Anesthesiology Authors: Vikas N. O'Reilly ‐Shah Tags: CORRESPONDENCE Source Type: research

Caution with the Posey ® Cufflator™ cuff pressure manometers
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 6, 2017 Category: Anesthesiology Authors: Mathew B. Kiberd, Anna K. Swenson ‐Schalkwyk, Thomas J. Caruso Tags: CORRESPONDENCE Source Type: research

Judging causal associations in observational research on caudal anesthesia and hypospadias repair
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 6, 2017 Category: Anesthesiology Authors: Bishr Haydar Tags: CORRESPONDENCE Source Type: research

Ultra ‐modified Rapid Sequence Induction
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 6, 2017 Category: Anesthesiology Authors: Ketan Kulkarni, Priyanka Karnik, Nandini Dave, Madhu Garasia Tags: CORRESPONDENCE Source Type: research

Xenon ‐augmented pediatric anesthesia: A small step closer?
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 6, 2017 Category: Anesthesiology Authors: Hannah Gill Tags: EDITORIAL Source Type: research

In this issue: December 2017
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - November 6, 2017 Category: Anesthesiology Authors: Andrew Davidson Tags: IN THIS ISSUE Source Type: research

Total intravenous anesthesia vs single pharmacological prophylaxis to prevent postoperative vomiting in children: A systematic review and meta ‐analysis
Summary BackgroundPostoperative nausea and postoperative vomiting are frequent but often missed complications after general anesthesia in pediatric patients. Because inhaled anesthetics are known to trigger postoperative vomiting, total intravenous anesthesia is often administered in high‐risk children to avoid the use of inhalational anesthesia. Since inhalational anesthesia might be advantageous in some situations, the question is raised whether administration of pharmacological prophylaxis offers equal protection from postoperative vomiting compared with total intravenous anesthesia alone. AimThe aim of this systemati...
Source: Pediatric Anesthesia - November 1, 2017 Category: Anesthesiology Authors: Maximilian S. Schaefer, Peter Kranke, Stephanie Weibel, Robert Kreysing, Janika Ochel, Peter Kienbaum Tags: SYSTEMATIC REVIEW Source Type: research

Informed consent in pediatric anesthesiology
ConclusionsMost pediatric preanesthesia discussions include ≥5 informed consent elements and describe the plan, mention risks, and mention benefits. Inclusion of these latter 3 consent elements was associated with parental recall of these elements but not understanding. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 27, 2017 Category: Anesthesiology Authors: Katherine R. Gentry, Katherine Lepere, Douglas J. Opel Tags: RESEARCH REPORT Source Type: research

Poor performance of main ‐stream capnography in newborn infants during general anesthesia
Summary BackgroundEndtidal (ET) measurement of carbon dioxide is well established for intraoperative respiratory monitoring of adults and children, but the method's accuracy for intraoperative use in small newborn infants has been less extensively investigated. AimsThe aim of this study was to compare carbon dioxide from ET measurements with arterialized capillary blood samples in newborn infants during general anesthesia and surgery. MethodsEndtidal carbon dioxide was continuously measured during anesthesia and surgery and compared with simultaneous blood gas analyses obtained from capillary blood samples. Fifty‐nine sa...
Source: Pediatric Anesthesia - October 26, 2017 Category: Anesthesiology Authors: Victoria Karlsson, Bengt Sporre, Lena Hellstr öm‐Westas, Johan Ågren Tags: RESEARCH REPORT Source Type: research

The child's behavior during inhalational induction and its impact on the anesthesiologist's sevoflurane exposure
Summary BackgroundSevoflurane is commonly used for inhalational inductions in children, but the personnel's exposure to it is potentially harmful. Guidance to reduce gas pollution refers mainly to technical aspects, but the impact of the child's behavior has not yet been studied. AimsThe purpose of this study was to determine how child behavior, according to the Frankl Behavioral Scale, affects the amount of waste sevoflurane in anesthesiologists’ breathing zones. MethodsSixty‐eight children aged 36‐96 months undergoing elective ENT surgery were recruited for this prospective, observational investigation. After o...
Source: Pediatric Anesthesia - October 26, 2017 Category: Anesthesiology Authors: Jennifer Herzog ‐Niescery, Heike Vogelsang, Martin Bellgardt, Nikolaj Matthias Botteck, Hans‐Martin Seipp, Horst Bartz, Thomas Peter Weber, Philipp Gude Tags: RESEARCH REPORT Source Type: research

What is the best size predictor for dose in the obese child?
Summary Lean body mass is commonly proposed for anesthesia maintenance drug dosing calculations. However, total body mass used with allometric scaling has been shown to be better for propofol in obese adults and children. Fat‐free mass has also been used instead of lean body mass. Fat‐free mass is essentially the same as lean body mass but excludes a small percentage of mass of lipids in cell membranes, CNS, and bone marrow. Normal fat mass is a size descriptor that partitions total body mass into fat‐free mass and fat mass calculated from total body mass minus fat‐free mass. The relative influence of fat mass comp...
Source: Pediatric Anesthesia - October 26, 2017 Category: Anesthesiology Authors: Brian J Anderson, Nick HG Holford Tags: EDUCATIONAL REVIEW Source Type: research

Nurse ‐driven analgesia and sedation in pediatric patients with univentricular hearts requiring extracorporeal life support after first‐stage palliation surgery: A pilot study
ConclusionA nurse‐driven protocol for analgesia and sedation of children with extracorporeal life support is feasible. Patients with extracorporeal life support do not need deeper sedation levels and have not higher cumulative sedation requirements than children without extracorporeal life support. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 24, 2017 Category: Anesthesiology Authors: J örg Michel, Michael Hofbeck, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Walter Jost, Christian Schlensak, Matthias Kumpf, Gunnar Blumenstock, Felix Neunhoeffer Tags: RESEARCH REPORT Source Type: research

Role of ultrasound measuring position and ventilation pressure in determining correct tube size in children
Summary BackgroundUltrasound measurements of the airway are useful for determining correctly sized, uncuffed endotracheal tubes in children. AimsThe primary objective of this study was to evaluate the influence of ventilation pressure on the sonographically measured tracheal diameter at different levels. MethodsA total of 100 patients (under 7 years) were enrolled in this study. Six sonographic measurements of minimal transverse diameters at 3 locations (vocal chords, cricoid cartilage, and proximal trachea) and at 2 different ventilation pressures (0 and 15 mbar) were performed before the intubation procedure. The intubat...
Source: Pediatric Anesthesia - October 24, 2017 Category: Anesthesiology Authors: Christoph Schramm, Luzie S. Eisleben, Jens Kessler, Katrin Jensen, Konstanze Plaschke Tags: RESEARCH REPORT Source Type: research

A quality improvement initiative to increase the safety of pediatric emergency airway management
ConclusionsQuality improvement initiatives targeting emergency airway management may be successfully implemented in the emergency department and are associated with a reduction in adverse intubation‐related events. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 24, 2017 Category: Anesthesiology Authors: Elliot Long, Domenic R. Cincotta, Joanne Grindlay, Stefano Sabato, Emmanuelle Fauteux ‐Lamarre, David Beckerman, Terry Carroll, Nuala Quinn, Tags: RESEARCH REPORT Source Type: research

A retrospective comparison of thoracic epidural infusion and multimodal analgesia protocol for pain management following the minimally invasive repair of pectus excavatum
ConclusionImplementation of a standardized comprehensive multimodal analgesic protocol following minimally invasive repair of pectus excavatum resulted in equivalent analgesia with a modest reduction in length of stay when compared to thoracic epidural. We did not observe an opioid sparing effect in our thoracic epidural which may reflect technique variability. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 24, 2017 Category: Anesthesiology Authors: Janice Y. Man, Harshad G. Gurnaney, Scott R. Dubow, Theresa J. DiMaggio, Gina R. Kroeplin, N. Scott Adzick, Wallis T. Muhly Tags: RESEARCH REPORT Source Type: research

Determination of the optimal depth of a left internal jugular venous catheter in infants: A prospective observational study
Summary BackgroundFew reports exist regarding the optimal depth of a left‐sided central venous catheter in pediatric patients. We aimed to provide a guideline for the optimal depth of central venous catheters at the left internal jugular vein in infants, using anatomical landmarks, age, height, and weight. MethodsA two‐stage study was conducted. In the first observational study, infants aged ≤1 year and scheduled for elective surgery requiring a central venous catheter were enrolled. The tip of the central venous catheter was confirmed using transthoracic echocardiography. Linear regression modeling was perform...
Source: Pediatric Anesthesia - October 17, 2017 Category: Anesthesiology Authors: Ji ‐Hyun Lee, Hyo‐Jin Byon, Yoon‐Hyeong Choi, In‐Kyung Song, Jin‐Tae Kim, Hee‐Soo Kim Tags: RESEARCH REPORT Source Type: research

Optimal management of apparatus dead space in the anesthetized infant
Summary Mechanical ventilation of the anesthetized infant requires careful attention to equipment and ventilator settings to assure optimal gas exchange and minimize the potential for lung injury. Apparatus dead space, defined as dead space resulting from devices placed between the endotracheal tube and the Y‐piece of the breathing circuit, is the primary source of dead space controlled by the clinician. Due to the small tidal volumes required by infants and neonates, it is easy to create excessive apparatus dead space resulting in unintended hypercarbia or increased minute ventilation in an effort to achieve a desirable...
Source: Pediatric Anesthesia - October 17, 2017 Category: Anesthesiology Authors: Michael R. King, Jeffrey M. Feldman Tags: EDUCATIONAL REVIEW Source Type: research

A rare case of giant tongue teratoma: Anesthetic management in low resource settings
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 13, 2017 Category: Anesthesiology Authors: Ketan Kulkarni, Sushant Mane, Nigar Rumane, Shriyam Saran, Pushkar Desai Tags: CORRESPONDENCE Source Type: research

There's no anesthesia like no anesthesia
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 13, 2017 Category: Anesthesiology Authors: Leah C. Templeton, Rachana Sharma, T. Wesley Templeton Tags: CORRESPONDENCE Source Type: research

Pediatric estimating endotracheal tube “4‐3‐2‐1”: A mnemonic for an age‐based endotracheal tube selection
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 13, 2017 Category: Anesthesiology Authors: Jeremy H. Tsui, Ban C. H. Tsui Tags: CORRESPONDENCE Source Type: research

Nursing initiated tracheal extubation in PACU, the risk of  delegating critical anesthesiology tasks in the interest of speed
(Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 13, 2017 Category: Anesthesiology Authors: Adam C. Adler, Arvind Chandrakantan Tags: CORRESPONDENCE Source Type: research

A prospective audit of pain profiles following general and urological surgery in children
ConclusionPain management was inadequate in most of the groups studied, particularly after appendicectomy or umbilical hernia repair, with most children experiencing at least moderate pain on the day of and day after surgery. There was a need for a standardized management, with increased dual analgesia prescribing, to ensure that children receive adequate postoperative analgesia in hospital and at home. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 13, 2017 Category: Anesthesiology Authors: Caroline A. Wilson, David Sommerfield, Thomas F. E. Drake ‐Brockman, Claudia Lagrange, Anoop Ramgolam, Britta S. Ungern‐Sternberg Tags: RESEARCH REPORT Source Type: research

Rapid Response Team activation for pediatric patients on the acute pain service
This study is a quality improvement initiative that attempts to identify patient demographics and patterns associated with Rapid Response Team consultations for patients on the acute pain service. MethodsA retrospective review of all patients on the acute pain service from February 2011 until June 2015 was cross‐referenced with inpatients requiring consultation from the Rapid Response Team. Two independent practitioners reviewed electronic medical records to determine which events were likely associated with pain management interventions. ResultsOver a 4‐year period, 4872 patients were admitted to the acute pain servic...
Source: Pediatric Anesthesia - October 13, 2017 Category: Anesthesiology Authors: Maxwell Teets, Dmitry Tumin, Hina Walia, Jenna Stevens, Sharon Wrona, David Martin, Tarun Bhalla, Joseph D. Tobias Tags: RESEARCH REPORT Source Type: research

Changes in blood volume indicators and dynamic indicators measured with transpulmonary ultrasound velocity during blood depletion and repletion in a neonatal swine model
ConclusionTotal end‐diastolic volume and central blood volume changed during blood depletion and repletion, and differed between stages of hemorrhage. These indicators might be useful for assessing volume status instead of, or in addition to cardiac index and dynamic indicators. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 13, 2017 Category: Anesthesiology Authors: Manuel Martin ‐Flores, Alvaro F. Cisternas, Robin D. Gleed Tags: RESEARCH REPORT Source Type: research

Suitability of the forearm for non ‐invasive blood pressure measurement in children
ConclusionThe differences within mean ±1.96 standard deviations reside considerably outside the clinically accepted tolerance of ±5 mm Hg. Thus, the forearm may not be used interchangeably with upper limb BP readings in anesthetized healthy children. Future use of the forearm for BP measurement requires a validated anthropomorphically appropriate forearm cuff. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - October 13, 2017 Category: Anesthesiology Authors: David Greaney, Solmaz Nakhjavani, Fiona Desmond, Mark Tormey, Ian Dawkins, Brendan O'Hare Tags: RESEARCH REPORT Source Type: research