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Risk assessment and optimization strategies to reduce perioperative respiratory adverse events in Pediatric Anesthesia—Part 2: Anesthesia-related risk and treatment options

Perioperative respiratory adverse events are the most common cause of critical events in children undergoing anesthesia and surgery. While many risk factors remain unmodifiable, there are numerous anesthetic management decisions which can impact the incidence and impact of these events, especially in at-risk children.

Without training, they lacked knowledge. Without knowledge, they lacked confidence. Without confidence, they lacked victory (Julius Caesar)

Britta Regli-von Ungern-Sternberg AM FAHMS MD, PhD, DEAA, FANZA Chair of Paediatric anaesthesia, University of Western Australia; Consultant

HPLC-UV assay of tramadol and O-desmethyltramadol in human plasma containing other drugs potentially co-administered to participants in a paediatric population pharmacokinetic study

Multimodal analgesia is employed in paediatric pain management to maximise analgesia and minimise side effects. Tramadol is dosed at 1–1.5 mg/kg to treat severe pain in children but the assay for tramadol in plasma samples for pharmacokinetic and toxicology studies does not often consider concurrently administered medications.

Error traps in pediatric difficult airway management

Difficult 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.

Prime Minister’s Prize for pioneering WA anaesthetist

Congratulations to trailblazing Western Australian paediatric anaesthetist and researcher Professor Britta Regli-von Ungern-Sternberg, who has been awarded a prestigious Prime Minister’s Prize for Science for globally influential research that has made surgery and recovery safer for babies and children.

Intubation study points the way to safer surgery in babies

Perth researchers who were involved in an international study which examined two different techniques used to intubate newborns and young babies during surgery expect the findings to lead to a change in global practice.

Prestigious fellowship to help end the cycle of painful ear infections

A The Kids Research Institute Australia ear health researcher has received a prestigious national fellowship to support her search for new therapies to improve the lives of kids who suffer repeat middle ear infections.

Short-term outcomes in infants following general anesthesia with low-dose sevoflurane/dexmedetomidine/remifentanil versus standard dose sevoflurane (The TREX trial)

The Trial Remifentanil DEXmedetomidine trial aimed to determine if, in children < 2 years old, low-dose sevoflurane/dexmedetomidine/remifentanil anesthesia is superior to standard dose sevoflurane anesthesia in terms of global cognitive function at 3 years of age.

3-Dimensional Virtual Reality Versus 2-Dimensional Video for Distraction during the Induction of Anesthesia in Children to Reduce Anxiety: A Randomized Controlled Trial

Preoperative anxiety is common in children. It can contribute to negative experiences with anesthetic induction and may cause adverse physiological and psychological effects. Virtual reality (VR) and electronic tablet devices are 2 audiovisual distraction tools that may help to reduce anxiety and enhance the preoperative experience. This study aimed to compare the use of an immersive 3-dimensional (3D) VR to 2-dimensional (2D) video on anxiety in children during induction of general anesthesia.

Feasibility of the pre-operative measurement of fractional exhaled nitric oxide and respiratory mechanics to predict respiratory outcomes in children undergoing general anaesthesia

Peri-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.