Paediatric anaesthesia
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Burnout is a state of emotional and physical exhaustion associated with internal and external stressors. Drivers of burnout include the expectation that we as physicians place our patients first, ahead of our own self-care; that seeking help is a sign of weakness in the culture of medicine; practice inefficiencies, including those imposed by electronic medical records; and a lack of personal resilience suffered by many physicians. The costs of burnout are high, including a decrement in the quality of care, increased turnover, and physician suicide. ⋯ We can enhance our resilience with a variety of tools, including meditation and mindfulness practice. Fortunately, these practices are becoming more mainstream and readily available to us. This article will briefly review the problem of burnout, including drivers and costs, and then focus on meditation and mindfulness practices that we may embrace in order to become more resilient.
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Paediatric anaesthesia · Dec 2020
Review Meta AnalysisEfficacy of caudal versus intravenous administration of α2 adrenoceptor agonists to prolong analgesia in pediatric caudal block: A systematic review and meta-analysis.
α2 adrenoceptor agonists have been proposed as adjuncts to prolong analgesia in pediatric caudal block. The aim of this meta-analysis was to compare the analgesic efficacy of caudal vs intravenous α2 adrenoceptor agonists during pediatric caudal block. ⋯ Caudal α2 adrenoceptor agonists as adjuncts to local anesthetic during pediatric caudal block are more effective than intravenous injection. However, the results were affected by small sample size and significant heterogeneity.
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Paediatric anaesthesia · Dec 2020
Review Meta AnalysisEfficacy of caudal versus intravenous administration of α2 adrenoceptor agonists to prolong analgesia in pediatric caudal block: A systematic review and meta-analysis.
α2 adrenoceptor agonists have been proposed as adjuncts to prolong analgesia in pediatric caudal block. The aim of this meta-analysis was to compare the analgesic efficacy of caudal vs intravenous α2 adrenoceptor agonists during pediatric caudal block. ⋯ Caudal α2 adrenoceptor agonists as adjuncts to local anesthetic during pediatric caudal block are more effective than intravenous injection. However, the results were affected by small sample size and significant heterogeneity.
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Paediatric anaesthesia · Dec 2020
Review2020 Guidelines for Conducting Plastic Reconstructive Short-Term Surgical Projects in Low-Middle Income Countries.
Many low- or middle-income countries (LMICs) continue to suffer from a lack of safe and timely essential and emergency surgery despite growing attention to this problem. Short-term surgical projects (STSPs) continue to play an important role in addressing LMIC unmet surgical need and strengthening local healthcare systems. Guidelines here present recommendations for performing plastic reconstructive STSPs for pediatric patients in a safe, ethical, and effective manner. ⋯ Host education during STSPs has become crucial as LMICs ramp up training at a time when their surgical volumes remain grossly behind well-resourced countries. Recommendations here aim to assist organizations, hosts, and volunteers as they navigate the enormously complex and ever changing STSP environment. Patient safety and transfer of knowledge and skills should be central concerns of all who participate in this highly rewarding endeavor.