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Pain and recovery profiles following common orthopaedic surgeries in children

Little evidence exists on the postoperative trajectory after paediatric orthopaedic surgery. Pain and behavioural disturbance can have short- and long-term impacts on children and their families. An improved understanding of procedure-specific postoperative trajectories can enhance recovery. The primary outcome was to examine the duration and severity of postoperative pain experienced by children undergoing 10 commonly performed orthopaedic procedures.

Inhaled nebulised adrenaline delivery in children and adults: A simulation study

Sometimes, there is an urgent need to administer inhaled adrenaline to children, awake, sedated or anaesthetised to treat asthma, bronchospasm, croup, and suspected laryngeal/pharyngeal oedema or stridor, which can become severe or even life-threatening. To better inform emergency dosing and administration guidelines, we aimed to quantify the amount of adrenaline delivered for inhalation from a nebuliser, in a simulated experimental delivery set-up for spontaneously breathing children and adults, either via an anaesthetic face mask, a Laryngeal Mask Airway or an Endotracheal tube.

Environmental exposure to air pollution and pollen and the risk of perioperative respiratory adverse events in paediatric anaesthesia: A narrative review

This narrative review article summarises the current evidence on environmental exposures before surgery. There is emerging evidence suggesting that environmental exposures before surgery, namely exposure to air pollution and allergenic pollen, may significantly influence the risk of these events occurring.

Current post-tonsillectomy analgesia practices among Australian and New Zealand anesthetists, and opinions on non-opioid alternatives

Children experience significant pain following extracapsular tonsillectomy surgery, and while opioids are often prescribed to treat this, clinicians may be wary of their adverse side effects, leading to variation in practice. There is a need for improved post-tonsillectomy pain management in children. 

Association of preoperative nocturnal hypoxaemia nadir and fentanyl ventilatory sensitivity in children with obstructive sleep apnoea undergoing general anaesthesia

Obstructive sleep apnoea (OSA) has been thought to increase the risk of respiratory depression from opioids. The primary aim of this study was to assess whether preoperative hypoxaemia by sleep study pulse oximetry imparts greater opioid sensitivity.

Difficult or impossible facemask ventilation in children with difficult tracheal intubation: a retrospective analysis of the PeDI registry

Difficult facemask ventilation is perilous in children whose tracheas are difficult to intubate. We hypothesised that certain physical characteristics and anaesthetic factors are associated with difficult mask ventilation in paediatric patients who also had difficult tracheal intubation.

Patient and Process Outcomes among Pediatric Patients Undergoing Appendectomy during the COVID-19 Pandemic: An International Retrospective Cohort Study

COVID-19 forced healthcare systems to make unprecedented changes in clinical care processes. The authors hypothesized that the COVID-19 pandemic adversely impacted timely access to care, perioperative processes, and clinical outcomes for pediatric patients undergoing primary appendectomy.

Perioperative management of infant inguinal hernia surgery; a review of the recent literature

Inguinal hernia surgery is one of the most common electively performed surgeries in infants. The common nature of inguinal hernia combined with the high-risk population involving a predominance of preterm infants makes this a particular area of interest for those concerned with their perioperative care. Despite a large volume of literature in the area of infant inguinal hernia surgery, there remains much debate amongst anesthetists, surgeons and neonatologists regarding the optimal perioperative management of these patients.

The effect of the COVID-19 pandemic on paediatric anaesthesia research as evidenced by the contrasting recruitment experiences of centres in Australia and Scotland

At two hospitals in Western Australia, we conducted a prospective, open-label, randomised, controlled trial of 240 patients undergoing tonsillectomy to investigate the effect of chewing a confectionery jelly snake on postoperative nausea and vomiting. The results were published in Anaesthesia Critical Care & Pain Medicine. Recruitment for this study was completed uneventfully between July 2018 and August 2019.

Perioperative intravenous lidocaine use in children

Perioperative pain management impacts patient morbidity, quality of life, and hospitalization cost. In children, it impacts not only the child, but the whole family. Adjuncts for improved perioperative analgesia continue to be sought to minimize adverse side effects associated with opioids and for those in whom regional or neuraxial anesthesia is not suitable.