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Children
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Advances in Pediatric Anesthesiology, Pain and Perioperative Medicine
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Advances in Pediatric Anesthesiology, Pain and Perioperative Medicine

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Anesthesiology, Perioperative and Pain Medicine".

Deadline for manuscript submissions: closed (15 December 2022) | Viewed by 7277

Special Issue Editors

Dr. Eugene Kim

E-Mail Website
Guest Editor
1. Division of Pain Medicine, Department of Anesthesiology Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA
2. Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Interests: pediatrics; pain medicine; pediatric anesthesiology; health disparities; health technology
Dr. Jonathan Tan

E-Mail Website
Guest Editor
1. Department of Anesthesiology Critical Care Medicine, Children’s Hospital Los Angeles, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
2. Spatial Sciences Institute at the University of Southern California, Los Angeles, CA, USA
Interests: pediatric anesthesiology; spatial science; clinical informatics; geographic information system science; social and environmental determinants of health; patient safety and quality

Special Issue Information

Dear Colleagues,

Medical, surgical, and public health innovations have changed the epidemiology of health among neonates, infants, and children. Pediatric patients are more complex because of advances in treatments for acute and chronic health conditions. The changing landscape of health and complexity of pediatric patients extends to the fields of anesthesiology and perioperative and pain medicine. This Special Issue seeks to publish interdisciplinary research that explores the current and future directions of pediatric anesthesiology and perioperative and pain medicine in critical areas of medical practice that have and will continue to shape this field for years to come. We welcome manuscripts that consider the increasing complexity of children requiring anesthesiology and pain and perioperative medicine with a focus on recent evidence-based innovations, technologies, and changes to care paradigms that respond to the evolving landscape of health among children. Literature reviews, original research, and other important commentaries that highlight this work are welcome. 

Dr. Eugene Kim
Dr. Jonathan Tan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric anesthesiology
  • pediatric pain medicine
  • pediatric perioperative medicine
  • pediatric chronic pain
  • pediatric acute pain
  • pediatric regional anesthesia
  • innovation
  • technology
  • health equity

Published Papers (3 papers)

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Research

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11 pages, 2027 KiB  
Article
A Survey of Paediatric Rapid Sequence Induction in a Department of Anaesthesia
by Lloyd Duncan, Michelle Correia and Palesa Mogane
Children 2022, 9(9), 1416; https://doi.org/10.3390/children9091416 - 19 Sep 2022
Cited by 2 | Viewed by 1975
Abstract
(1) Background: Rapid sequence induction (RSI) is carried out by anaesthetists to secure the airway promptly in patients who are at risk of aspirating gastric content during induction of anaesthesia. RSI requires variation in the paediatric population. We conducted a survey to investigate [...] Read more.
(1) Background: Rapid sequence induction (RSI) is carried out by anaesthetists to secure the airway promptly in patients who are at risk of aspirating gastric content during induction of anaesthesia. RSI requires variation in the paediatric population. We conducted a survey to investigate current practice of paediatric RSI by anaesthetists. (2) Methods: A descriptive, contextual, cross-sectional research design was followed. The study population consisted of all anaesthetists working in the Department of Anaesthesia at the University of the Witwatersrand. Data was collected in the form of a self-administered questionnaire. (3) Results: Of 138 questionnaires that were distributed, 126 were completed. Clinical indication for RSI was predominantly for appendicitis with peritonitis (115/124; 92.7%). Preoxygenation was performed by 95.1% of anaesthetists for children, 87% for infants and 89.4% for neonates. Cricoid pressure was used significantly more in children (56%) than in infants (20.8%) and neonates (10.3%) (p < 0.001). Rocuronium was the paralytic agent of choice in children (42.7%) and infants (38.2%), while cisatracurium was used most frequently in neonates (37.4%). Suxamethonium was used least in neonates. Cuffed ETTs were used most frequently for children (99.2%) and least for neonates (49.6%). Eighty-five percent of anaesthetists omitted cricoid pressure during RSI for pyloromyotomy, for which a controlled RSI was performed more by consultants and senior registrars (p < 0.01). A classic RSI was performed by 53.6% of anaesthetists for laparotomy for small bowel obstruction. Consultants and PMOs were more likely to intubate a child for forearm MUA who was starved for 6 h and received opioids (p < 0.05). Controlled RSI with cisatracurium was the technique of choice for Tenkhoff insertion in a child with renal failure. (4) Conclusions: RSI practice for paediatric patients varied widely among anaesthetists. This may be attributed to a combination of anaesthetic experience, training in paediatric anaesthesia, and patient specific factors, along with the individualised clinical scenario’s aspiration risk. A controlled RSI technique appears to be implemented more frequently by anaesthetists with increased experience. Full article
(This article belongs to the Special Issue Advances in Pediatric Anesthesiology, Pain and Perioperative Medicine)
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14 pages, 1961 KiB  
Article
Association between the Use of Quantitative Sensory Testing and Conditioned Pain Modulation and the Prescription of Medication and Interventional Procedures in Children with Chronic Pain Conditions
by Alice Bruneau, Catherine E. Ferland, Rafael Pérez-Medina-Carballo, Marta Somaini, Nada Mohamed, Michele Curatolo, Jean A. Ouellet and Pablo Ingelmo
Children 2022, 9(8), 1157; https://doi.org/10.3390/children9081157 - 02 Aug 2022
Cited by 5 | Viewed by 1955
Abstract
The evidence supporting the use of pharmacological treatments in pediatric chronic pain is limited. Quantitative sensory testing (QST) and conditioned pain modulation evaluation (CPM) provide information on pain phenotype, which may help clinicians to tailor the treatment. This retrospective study aimed to evaluate [...] Read more.
The evidence supporting the use of pharmacological treatments in pediatric chronic pain is limited. Quantitative sensory testing (QST) and conditioned pain modulation evaluation (CPM) provide information on pain phenotype, which may help clinicians to tailor the treatment. This retrospective study aimed to evaluate the association between the use of QST/CPM phenotyping on the selection of the treatment for children with chronic pain conditions. We retrospectively analyzed the medical records of 208 female patients (mean age 15 ± 2 years) enrolled in an outpatient interdisciplinary pediatric complex pain center. Pain phenotype information (QST/CPM) of 106 patients was available to the prescribing physician. The records of 102 age- and sex-matched patients without QST/CPM were used as controls. The primary endpoint was the proportion of medications and interventions prescribed. The secondary endpoint was the duration of treatment. The QST/CPM group received less opioids (7% vs. 28%, respectively, p < 0.001), less anticonvulsants (6% vs. 25%, p < 0.001), and less interventional treatments (29% vs. 44%, p = 0.03) than controls. Patients with an optimal CPM result tended to be prescribed fewer antidepressants (2% vs. 18%, p = 0.01), and patients with signs of allodynia and/or temporal summation tended to be prescribed fewer NSAIDs (57% vs. 78%, p = 0.04). There was no difference in the duration of the treatments between the groups. QST/CPM testing appears to provide more targeted therapeutic options resulting in the overall drop in polypharmacy and reduced use of interventional treatments while remaining at least as effective as the standard of care. Full article
(This article belongs to the Special Issue Advances in Pediatric Anesthesiology, Pain and Perioperative Medicine)
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Review

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10 pages, 406 KiB  
Review
Intranasal Dexmedetomidine as Sedative for Medical Imaging in Young Children: A Systematic Review to Provide a Roadmap for an Evidence-Guided Clinical Protocol
by Kato Hermans, Larissa Ramaekers, Jaan Toelen, Koen Vanhonsebrouck and Karel Allegaert
Children 2022, 9(9), 1310; https://doi.org/10.3390/children9091310 - 28 Aug 2022
Cited by 1 | Viewed by 2759
Abstract
There is an increasing need for effective anxiety and pain reduction during medical imaging procedures in children, addressed by non-pharmacological or pharmacological approaches. Dexmedetomidine is a fairly recently marketed, selective α2-adrenergic agonist that can be administered intranasally. To develop an evidence-guided clinical protocol, [...] Read more.
There is an increasing need for effective anxiety and pain reduction during medical imaging procedures in children, addressed by non-pharmacological or pharmacological approaches. Dexmedetomidine is a fairly recently marketed, selective α2-adrenergic agonist that can be administered intranasally. To develop an evidence-guided clinical protocol, we investigated the (side) effects, preconditions and safety aspects following intranasal dexmedetomidine administration in children (1 month–5 years) for procedural sedation during medical imaging. To this end, a systematic search (PubMed, Embase and CINAHL (12/2021)) was performed to identify studies on intranasal dexmedetomidine for procedural sedation for medical imaging (computer tomography and magnetic resonance imaging). Following screening and quality assessment, eight studies were retained. Nasal nebulization was considered the best administration method, dosing varied between 2 and 4 µg/kg (age-dependent) 30–45 min prior to imaging and contraindications or restrictions with respect to oral intake were somewhat consistent across studies. Valid sedation scores and monitoring of vital signs were routinely used to assess sedation and the need for rescue dosing (different approaches), whereas discharge was generally based on Aldrete score (score ≥ 9). Heart rate, blood pressure and saturation were routinely monitored, with commonly observed bradycardia or hypotension (decrease by 20%). Based on these findings, a roadmap for evidence-guided clinical protocol was generated. Full article
(This article belongs to the Special Issue Advances in Pediatric Anesthesiology, Pain and Perioperative Medicine)
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