Last Updated: 7/10/2023
Garcia-Marcinkiewicz AG, Lee LK, Haydar B, Fiadjoe JE, Matava CT, Kovatsis PG, Peyton J, Stein ML, Park R, Taicher BM, Templeton TW; PeDI Collaborative. Difficult or impossible facemask ventilation in children with difficult tracheal intubation: a retrospective analysis of the PeDI registry. Br J Anaesth. 2023 Apr 17:S0007-0912(23)00122-8. doi: 10.1016/j.bja.2023.02.035. PMID: 37076335
What we know?
It is not clear what factors are associated with difficult facemask ventilation in children in whom tracheal intubation was difficult.
What This Article Tells Us
An analysis of a multicenter registry for children with difficult tracheal intubation showed that the incidence of difficult mask ventilation was 9%, and was more likely in infants and patients with increased weight, being less than 5th percentile in weight for age, or having Treacher-Collins syndrome, glossoptosis, or limited mouth opening.
The study suggests that strategies such as use of a supraglottic airway, or use of a neuromuscular blocking agent can minimize the incidence of difficult mask ventilation.
Louër R, Szeto M, Grasfield R, McClain CD, Urman RD, Brovman EY. Trends in pediatric non-operating room anesthesia: Data from the National Anesthesia Clinical Outcomes Registry. Paediatr Anaesth. 2023 Jun;33(6):446-453. doi: 10.1111/pan.14644. PMID: 36726283
What is already known?
Non-operating room anesthesia is a prominent segment of pediatric anesthetic encounters, but there is a limited amount of data to objectively describe how large of a segment of anesthesia practice it is across the United States.
What this article adds?
Review of the National Anesthesia Clinical Outcomes Registry data shows that 22.7% of pediatric anesthetic encounters within the United States occur outside of the operating room, a majority of which occur in gastroenterology and radiology suites.
Virtual reality in pediatrics, effects on pain and anxiety: A systematic review and meta-analysis update.
Tas FQ, van Eijk CAM, Staals LM, Legerstee JS, Dierckx B.
Paediatr Anaesth. 2022 Dec;32(12):1292-1304.
PMID: 35993398 DOI: 10.1111/pan.14546. Epub 2022 Sep 1.
- Medical procedures are often accompanied by pain and anxiety in pediatric patients. A relatively new technique to reduce pediatric pain and anxiety is virtual reality.
What This Article Tells Us
- The current updated systematic review and meta-analysis indicates that virtual reality is a useful tool to reduce pain and anxiety in pediatric patients undergoing a range of medical procedures as it significantly decreases pain and anxiety outcomes when compared to care as usual.
Ultrasound Evaluation of Gastric Emptying Time in Healthy Term Neonates after Formula Feeding
Jennifer J Lee, MD; Jerri C Price, MD, PhD; Andrew Duren, MD; Alon Shertzer, MD; Robert Hannum III, MD; Francis A Akita, MD; Shuang Wang, PhD; Judy H Squires, MD; Oliver Panzer, MD; Jacquelin Herrera, BS
Anesthesiology; June 2021; 134(6):845–851
PMID: 33861856 DOI: 10.1097/aln.0000000000003773
- The temporal kinetics of gastric emptying in formula-fed neonates are incompletely understood • Currently, American Society of Anesthesiologists guidelines recommend 6 h of fasting in formula-fed neonates and infants before anesthesia
What This Article Tells Us
- Serial ultrasound imaging of the gastric antrum in healthy term neonates after formula feeding reveals gastric emptying times ranging from 45 to 150 min
- These observations suggest that preanesthesia fasting of healthy term neonates could be substantially shorter than is currently recommended.
Availability of Inpatient Pediatric Surgery in the United States
Michael L McManus, MD, MPH; Urbano L França, PhD
Anesthesiology; 2021; 134(6):852–861
PMID: 33831167 DOI: 10.1097/aln.0000000000003766
Pediatric hospital care in the United States has been naturally consolidating. • In 2015, the American College of Surgeons launched its Children’s Surgery Verification Quality Improvement Program to promote regionalization and improve the quality of pediatric surgical care.
What This Article Tells Us
- Before the start of the American College of Surgeons Children’s Surgery Verification Quality Improvement Program, pediatric surgical care was highly concentrated, with less than 7% of hospitals responsible for more than 80% of procedures. Nearly half of all pediatric procedures undertaken outside of these centers involved teenagers.
Effects of Premedication With Midazolam on Recovery and Discharge Times After Tonsillectomy and Adenoidectomy
Andrew Garcia, Elizabeth A Clark, Sohel Rana, Diego Preciado, George M Jeha, Omar Viswanath, Ivan Urits, Alan D Kaye, Claude Abdallah
Cureus; Febraury 3 2021; 13(2):e13101
PMID: 33728122 DOI: 10.7759/cureus.13101
What This Article Tells Us
- Premedication with midazolam was not associated with prolonged emergence or discharge time or higher incidence of complications after anesthesia for T&A in patients with OSA.
