Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2020
Anesthetic Management of Pediatric Patients with Niemann-Pick Disease Type C for Intrathecal 2-hydroxypropyl-β-cyclodextrin Injection.
Niemann-Pick disease type C is an autosomal-recessive, lysosomal storage disorder with variable age of onset and a heterogeneous clinical presentation that includes neurological, psychiatric, and visceral findings. Serial intrathecal injections of 2-hydroxypropyl-beta-cyclodextrin are being evaluated as a treatment modality for Niemann-Pick disease type C with a subset of patients requiring anesthesia for this procedure. ⋯ Our findings suggest that general anesthesia induced via inhalation induction and maintained with volatile anesthetic via mask or supraglottic airway is a safe and effective option for pediatric patients with Niemann-Pick disease type C undergoing serial intrathecal injections of 2-hydroxypropyl-beta-cyclodextrin, supporting this technique as a viable option for anesthetic care in these patients.
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Paediatric anaesthesia · Jul 2020
The Effect of Intraoperative Methadone During Pediatric Cardiac Surgery on Postoperative Opioid Requirements.
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 improve perioperative pain control and decrease overall perioperative use of opioid analgesics and sedatives. ⋯ The use of intraoperative methadone appears to be a reasonable alternative to the use of fentanyl with potential other benefits both intra- and postoperatively of decreased total dose of opioids and other sedatives. Future studies will assess for any improvement in total postoperative opioid requirements during the total hospital stay, and potential use of methadone by the ICU team.
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Paediatric anaesthesia · Jul 2020
Observational StudyMedical Simulation Utilization among Pediatric Anesthesiology Fellowship Programs.
Simulation-based education is a mainstay in education of pediatric anesthesiology trainees. Despite the known benefits, there is variability in its use and availability among various pediatric anesthesiology fellowship programs. ⋯ 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.
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Paediatric anaesthesia · Jul 2020
Incidence and risk factors of preoperative anxiety in Spanish-speaking children living in a Spanish-speaking country.
Most research on preoperative anxiety has focused on non-Latino populations. A study performed in the USA found that children from Spanish-speaking Latino families experienced higher anxiety than children from English-speaking families. ⋯ 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.
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Paediatric anaesthesia · Jul 2020
East/West Visiting Scholars in Pediatric Anesthesia Program (ViSiPAP): Developing Tomorrow's Pediatric Anesthesia Leaders.
Promoting and retaining junior faculty are major challenges for many medical schools. High clinical workloads often limit time for scholarly projects and academic development, especially in anesthesiology. To address this, we created the East/West Visiting Scholars in Pediatric Anesthesia Program (ViSiPAP). ⋯ Moreover, ViSiPAP provides opportunities for women and underrepresented in medicine faculty. This program can help develop today's junior faculty into tomorrow's leaders in pediatric anesthesia. We advocate for expanding the concept of ViSiPAP to other institutions in academic medicine.