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Research
Error traps in pediatric difficult airway managementDifficult airway management in children is associated with significant morbidity. This narrative review on error traps in airway management aims to highlight the common pitfalls and proposes solutions to optimize best practices for pediatric difficult airway management. We have categorized common errors of pediatric difficult airway management into three main error traps.
Research
Impact of honey on post-tonsillectomy pain in children (BEE PAIN FREE Trial): a multicentre, double-blind, randomised controlled trial*Tonsillectomy, a common childhood surgery, is associated with difficult postoperative recovery. Previous reviews provided low-grade evidence that honey may improve recovery. The BEE PAIN FREE study investigated whether honey alongside multimodal analgesia improved the recovery trajectory in children following tonsillectomy.
Research
Perioperative pediatric tonsillectomy analgesia: A single-center review of practice and cost-effectiveness analysisTonsillectomy is one of the most common pediatric surgeries and results in considerable postoperative pain. Insufficiently managed pain is costly, risks physiological and psychological consequences with multi-modal analgesia widely recommended to minimize opioid-based agents. We determined adherence to multi-modal analgesia guidelines and assessed cost-effectiveness. We undertook a cross-sectional cohort study at a tertiary pediatric institution in Perth, Western Australia, retrospectively identifying selected patients undergoing tonsillectomy over two discrete periods of 6-week duration.
Research
Prenatal Exposure to General Anesthesia and Childhood Behavioral DeficitExposure to surgery and anesthesia in early childhood has been found to be associated with an increased risk of behavioral deficits. While the US Food and Drug Administration (FDA) has warned against prenatal exposure to anesthetic drugs, little clinical evidence exists to support this recommendation. This study evaluates the association between prenatal exposure to general anesthesia due to maternal procedures during pregnancy and neuropsychological and behavioral outcome scores at age 10.
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Early life predictors of obstructive sleep apnoea in young adults: Insights from a longitudinal community cohort (Raine study)Obstructive sleep apnea (OSA) increases the risk of perioperative adverse events in children. While polysomnography (PSG) remains the reference standard for OSA diagnosis, oximetry is a valuable screening tool. The traditional practice is the manual analysis of desaturation clusters derived from a tabletop device using the McGill oximetry score. However, automated analysis of wearable oximetry data can be an alternative. This study investigated the accuracy of wrist-worn oximetry with automated analysis as a preoperative OSA screening tool.
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Feasibility of upper airway collapsibility measurements in anesthetized childrenPatients with a propensity for upper airway obstruction, including those with obstructive sleep apnea (OSA), are vulnerable in the perioperative period. OSA is an increasingly common disorder in children and, when present, is associated with an increased risk of perioperative respiratory adverse events (PRAE),1 morbidity, and mortality. Therefore, identifying at-risk patients is vital to provide tailored perioperative anesthetic management.
Research
Direct versus video laryngoscopy with standard blades for neonatal and infant tracheal intubation with supplemental oxygen: a multicentre, non-inferiority, randomised controlled trialTracheal intubation in neonates and infants is a potentially life-saving procedure. Video laryngoscopy has been found to improve first-attempt tracheal intubation success and reduce complications compared with direct laryngoscopy in children younger than 12 months.
News & Events
Paediatric anaesthetist named a WA Young Tall PoppyA leading paediatric anaesthetist and researcher focused on making anaesthesia safer and more comfortable for children has been named a 2022 Western Australian Young Tall Poppy.
Research
Mode of delivery and behavioral and neuropsychological outcomes in children at 10 years of agePrevious studies have reported that mode of delivery, particularly cesarean delivery is associated with neurodevelopmental outcomes in children. This study evaluates behavioral and neuropsychological test scores in children based on mode of delivery.
Research
Feasibility of the pre-operative measurement of fractional exhaled nitric oxide and respiratory mechanics to predict respiratory outcomes in children undergoing general anaesthesiaPeri-operative respiratory adverse events remain a major cause of morbidity and mortality in children undergoing general anaesthesia; those with asthma are at higher risk. The aim of this feasibility study was to determine whether pre-operative measurements of fractional exhaled nitric oxide and the forced oscillation technique are feasible in children, and to explore whether these measurements can predict peri-operative respiratory adverse events.