Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2025
ReviewError Traps in Developing a Pediatric Enhanced Recovery After Surgery (ERAS) Program.
Enhanced recovery after surgery (ERAS) pathways have been shown to improve patient outcomes, increase patient satisfaction, and decrease costs. First created and implemented in the adult population, these pathways are now commonplace and continue to expand in the pediatric realm. ⋯ Key themes include departmental and institutional support, stakeholder engagement, awareness of pathways, data management and dissemination, and long-term maintenance including Plan-Do-Study-Act (PDSA) cycles. Pathway development teams should be aware of these considerations and potential pitfalls, and focusing on them can promote long-term success for a well-designed pathway.
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Paediatric anaesthesia · Mar 2025
Retrospective Cohort Study of Perioperative Complications in Symptomatic and Asymptomatic Children Testing SARS-CoV-2-Positive Within 21 Days Before Surgery.
COVID-19 increases anesthetic risk in children, but understanding of complication differences by symptom presence and severity is limited. We hypothesized that symptomatic COVID-19+ children, especially with lower respiratory symptoms, would have higher perioperative complications than asymptomatic patients and that complications would be higher in all patients diagnosed < 6 days before anesthesia. ⋯ The presence of symptoms, particularly of the lower respiratory tract, should be strongly considered in the shared decision-making process between providers and families when discussing the potential delay of procedures in the setting of COVID-19.
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Paediatric anaesthesia · Mar 2025
Understanding Pediatric Anesthesiology Fellowship Interest: A National Survey of the Resident Experience.
The field of pediatric anesthesiology faces an impending shortage of fellowship-trained physicians. Despite this projection, fewer anesthesiology residents are opting to pursue a fellowship. To better understand the current perspective and motivation of trainees to pursue a career in pediatric anesthesiology, we surveyed anesthesiology residents across the United States. ⋯ The journey toward specializing in pediatric anesthesiology is influenced by a complex interplay of factors. Among these, enhanced exposure to challenging cases and advanced procedures during the residency phase is emerging as a critical element. Such exposure not only equips residents with the necessary skills and confidence to handle complex pediatric anesthesia cases but also plays a pivotal role in attracting more trainees to this essential subspecialty.
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Paediatric anaesthesia · Mar 2025
Understanding Racial and Ethnic Disparities in Perioperative Pain Management After Routine Pediatric Tonsillectomy.
Hispanic/Latino (H/L) patients are often excluded from studies addressing pain management. Limited data suggests disparities in administration of perioperative opioid analgesia. We hypothesize that H/L patients are less likely to have their pain assessed and managed appropriately with opioids following routine pediatric tonsillectomy. ⋯ Disparities in perioperative pain management following routine pediatric tonsillectomy exist. In contrast with current literature and our prior hypothesis, children of non-H/L ethnicity were less likely to receive opioids and more likely to have their pain assessed. Given H/L patients received fewer pain assessments, they are at risk for inferior pain management. Further understanding of factors driving differences in pain management may improve perioperative patient experience, quality of care, and aid in the creation of more standardized protocols.