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Children
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State-of-Art in Pediatric Anesthesia
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State-of-Art in Pediatric Anesthesia

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Emergency Medicine & Intensive Care Medicine".

Deadline for manuscript submissions: closed (1 June 2024) | Viewed by 10107

Special Issue Editor

Prof. Dr. Senthilkumar Sadhasivam

E-Mail Website
Guest Editor
UPMC Children’s Hospital of Pittsburgh, Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
Interests: pediatric and adult anesthesia; pain management; fetal anesthesia; regional anesthesia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue will focus on current and evidence-based updates related to pediatric anesthesia and pain management in children. Specialists in the field are invited to submit original clinical research articles and high-quality evidence-based reviews. Preferred topics of interest include, but are not limited to: anesthesia and perioperative pain relief for tonsillectomy in children; enhanced recovery after surgery in children; neonatal anesthesia; regional anesthesia and acute surgical pain management; opioid-free and opioid-sparing analgesia; perioperative methadone in children; anesthesia and staffing management in children's hospitals; pediatric airway management; common perioperative emergencies in children; management of children with complex medical history; pediatric cardiac anesthesia; pediatric transplant anesthesia; non-operating room anesthesia; and pediatric dental anesthesia.

We would additionally appreciate it if you could forward this to your team members and colleagues who may also be interested in the topic.

Thank you for your consideration. Please do not hesitate to contact us if you have any questions or suggestions.

Prof. Dr. Senthilkumar Sadhasivam
Guest Editor

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

  • anesthesia
  • children
  • surgical pain
  • opioids
  • regional anesthesia
  • pediatric anesthesia

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Related Special Issue

Published Papers (6 papers)

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11 pages, 962 KiB  
Article
Agony of Choice: Caudal Block versus Ilioinguinal/Iliohypogastric Nerve Block in Unilateral Orchidopexy
by Aybike Hofmann, Bernhard Koller, Franziska Vauth, Pirmin I. Zöhrer, Gregor Badelt and Wolfgang H. Rösch
Children 2024, 11(7), 800; https://doi.org/10.3390/children11070800 - 29 Jun 2024
Viewed by 948
Abstract
Objective: This prospective study aimed to compare the efficacy of caudal block (CB) and ilioinguinal/iliohypogastric nerve block (IINB) for providing additional analgesia during unilateral orchidopexy. Methods: Seventy-one boys aged <48 months, classified as ASA I/II, were assigned into CB (n = 37) [...] Read more.
Objective: This prospective study aimed to compare the efficacy of caudal block (CB) and ilioinguinal/iliohypogastric nerve block (IINB) for providing additional analgesia during unilateral orchidopexy. Methods: Seventy-one boys aged <48 months, classified as ASA I/II, were assigned into CB (n = 37) and IINB (n = 34) groups. Outcome measures included intra- and postoperative analgesic requirements, pain scores, and administration duration. Additional intraoperative analgesia was administered for a 10% increase in heart rate, while postoperative pain was assessed using the Children’s and Infants Postoperative Pain Scale (CHIPPS), with scores >4 prompting supplementary analgesia. Monitoring was extended for 24 h post-surgery. Results: CB significantly reduced the need for intraoperative (p < 0.001) and early postoperative (p = 0.008) analgesia compared to IINB. However, the CB group exhibited a slightly higher but non-significant analgesic requirement on the ward. No clinically relevant side effects were observed in either group. Conclusions: Both CB and IINB are effective and safe methods for providing regional analgesia during orchidopexy. CB demonstrates superior efficacy intraoperatively and in the early postoperative period, while IINB may offer advantages in the later recovery phase. However, additional analgesia is often required for orchidopexy, especially in outpatient settings. Full article
(This article belongs to the Special Issue State-of-Art in Pediatric Anesthesia)
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12 pages, 3523 KiB  
Article
Utilizing Peripheral Nerve Blocks for Pain Management in Pediatric Patients during Embolization and Sclerotherapy for Vascular Malformations
by Matthew Kocher, Maria Evankovich, Danielle R. Lavage, Sabri Yilmaz, Senthilkumar Sadhasivam and Mihaela Visoiu
Children 2024, 11(3), 368; https://doi.org/10.3390/children11030368 - 20 Mar 2024
Viewed by 1400
Abstract
Vascular anomalies are a diverse group of abnormal blood vessel developments that can occur at birth or shortly afterward. Embolization and sclerotherapy have been utilized as a treatment option for these malformations but may cause moderate-to-severe pain. This study aims to evaluate the [...] Read more.
Vascular anomalies are a diverse group of abnormal blood vessel developments that can occur at birth or shortly afterward. Embolization and sclerotherapy have been utilized as a treatment option for these malformations but may cause moderate-to-severe pain. This study aims to evaluate the utilization of peripheral nerve blocks in opioid consumption, pain scores, and length of stay. A retrospective chart review was conducted at the UPMC Children’s Hospital of Pittsburgh for all patients who underwent embolization and sclerotherapy between 2011 and 2020. Patient data were collected to compare opioid consumption, pain scores, and length of stay. In total, 854 procedures were performed on 347 patients. The morphine milligram equivalent per kilogram mean difference between groups was 0.9 (0.86, 0.95) with a p-value of <0.001. The pain score mean ratio was −1.17 (−2.2, −0.1) with a p-value of 0.027. The length of stay had an incident rate ratio of 0.94 (0.4, 2) and a p-value of 0.875. By decreasing opioid consumption and postoperative pain scores, peripheral nerve blocks may have utility in patients undergoing embolization and sclerotherapy while not clinically increasing the length of stay for patients. Their use should be individualized and carefully discussed with the interventional radiologist. Full article
(This article belongs to the Special Issue State-of-Art in Pediatric Anesthesia)
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10 pages, 212 KiB  
Article
Laryngeal Mask Airway Versus Endotracheal Intubation during Lacrimal Duct Stenosis Surgery in Children—A Retrospective Analysis
by Nicolas Leister, Ludwig M. Heindl, Alexander C. Rokohl, Bernd W. Böttiger, Christoph Menzel, Christoph Ulrichs and Volker C. Schick
Children 2024, 11(3), 320; https://doi.org/10.3390/children11030320 - 7 Mar 2024
Viewed by 1693
Abstract
Background: The use of laryngeal masks in the surgical treatment of infantile lacrimal duct stenosis is controversial due to the potential risk of aspiration. Aims: This study investigates airway procedures in children aged <6 years for surgery of lacrimal duct stenosis in a [...] Read more.
Background: The use of laryngeal masks in the surgical treatment of infantile lacrimal duct stenosis is controversial due to the potential risk of aspiration. Aims: This study investigates airway procedures in children aged <6 years for surgery of lacrimal duct stenosis in a tertiary care university hospital. Methods: After institutional approval, airway procedures, duration of anesthesiological measures, and airway-related complications were retrospectively analyzed. Patients were divided into two groups according to the airway procedures used (endotracheal tube [ET] vs. laryngeal mask [LMA] airway). Associations were calculated using the Chi-square test or Mann-Whitney U-test. Results: Clinical data of 84 patients (ET n = 36 [42.9%] vs. LMA n = 48 [57.1%]) were analyzed. There were no significant differences in surgical treatment, age distribution, and pre-existing conditions between the groups. None of the patients showed evidence of tracheal aspiration or changes in measured oxygen saturation. LMA airway shortened time for anesthesia induction (p = 0.006) and time for recovery/emergence period (p = 0.03). In contrast, the time to discharge from the recovery room was significantly prolonged using LMA (p = 0.001). A total of 7 adverse events were recorded. Five of these were directly or indirectly related to ET (laryngo-/bronchospasm; muscle relaxant residual). Conclusions: LMA airway for infantile lacrimal duct stenosis seems to be a safe procedure and should be used in appropriate pediatric patients due to its lower invasiveness, low complication rate, and time savings. Full article
(This article belongs to the Special Issue State-of-Art in Pediatric Anesthesia)
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11 pages, 1520 KiB  
Article
Safety Assessment of Prolonged Nerve Catheters in Pediatric Trauma Patients: A Case Series Study
by Nicole Verdecchia, Alexander Praslick and Mihaela Visoiu
Children 2024, 11(2), 251; https://doi.org/10.3390/children11020251 - 16 Feb 2024
Cited by 1 | Viewed by 1658
Abstract
Introduction: Nerve block catheters (NBCs) are increasingly used for pain management in pediatric trauma patients. While short-term efficacy has been well established, the long-term safety of NBCs is unknown. Methods/Cases: The retrospective chart review includes a cohort of nine pediatric trauma patients aged [...] Read more.
Introduction: Nerve block catheters (NBCs) are increasingly used for pain management in pediatric trauma patients. While short-term efficacy has been well established, the long-term safety of NBCs is unknown. Methods/Cases: The retrospective chart review includes a cohort of nine pediatric trauma patients aged 3–15 years who received 52 peripheral nerve block catheters and epidurals for pain management. This study aimed to investigate the potential risks associated with the prolonged use of NBCs in pediatric trauma cases. Results: The NBCs (48 peripheral catheters and 4 epidural catheters) were maintained for about 2 weeks. The number of catheters per patient varied from 1 to 11. The study noted a low frequency of catheter-related complications. No catheter-site infection or local anesthetic toxicity symptoms were reported. Discussion: These findings suggest that NBCs can be safely maintained for extended periods in pediatric trauma patients without significantly increasing complications. Careful monitoring and adherence to infection control practices remain paramount when implementing extended catheter use. Full article
(This article belongs to the Special Issue State-of-Art in Pediatric Anesthesia)
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5 pages, 146 KiB  
Case Report
Pre-Admission Oral Clonidine to Reduce Severe Pre-Operative Anxiety in Pediatric Patients with Behavioral Disorders: A Case Series
by Nicole Verdecchia, Ryan Nelson, Shante White and Franklyn Cladis
Children 2024, 11(3), 264; https://doi.org/10.3390/children11030264 - 20 Feb 2024
Viewed by 1550
Abstract
Controlling preoperative anxiety is necessary in pediatric patients to avoid adverse effects such as emergence delirium, behavioral problems, post-traumatic stress disorder, anxiety prior to future procedures, and increased analgesic doses in the recovery room. Some patients, especially ones with behavioral issues, have a [...] Read more.
Controlling preoperative anxiety is necessary in pediatric patients to avoid adverse effects such as emergence delirium, behavioral problems, post-traumatic stress disorder, anxiety prior to future procedures, and increased analgesic doses in the recovery room. Some patients, especially ones with behavioral issues, have a difficult time arriving at the hospital. Medications given at home can be helpful. We describe a case series of six patients who received pre-admission oral clonidine prior to arrival to the hospital. The patients were all able to enter the hospital without difficulty and the families reported less anxiety and more cooperation subjectively compared with previous experiences. Transient intraoperative hypotension was a side effect of oral clonidine, with no long-term sequelae. Full article
(This article belongs to the Special Issue State-of-Art in Pediatric Anesthesia)
7 pages, 3115 KiB  
Brief Report
Ultrasound-Guided Occipital Nerve Blocks as Part of Multi-Modal Perioperative Analgesia in Pediatric Posterior Craniotomies: A Case Series
by Jordan I. Gaelen, Michael R. King, John Hajduk, Angelica Vargas, David J. Krodel, Ravi D. Shah and Hubert A. Benzon
Children 2023, 10(8), 1374; https://doi.org/10.3390/children10081374 - 11 Aug 2023
Cited by 2 | Viewed by 2110
Abstract
Various regional anesthetics have been used for postoperative analgesia for pediatric craniotomy. In this case series, we report retrospectively collected data on postoperative pain and analgesic use in 44 patients who received ultrasound-guided occipital nerve blocks in addition to intravenous analgesic agents for [...] Read more.
Various regional anesthetics have been used for postoperative analgesia for pediatric craniotomy. In this case series, we report retrospectively collected data on postoperative pain and analgesic use in 44 patients who received ultrasound-guided occipital nerve blocks in addition to intravenous analgesic agents for posterior craniotomy procedures. In the immediate post-anesthesia care unit, pain was rated as zero or well controlled in 77% of patients, with only 43% requiring intravenous or demand patient-controlled analgesia opioids. There were no block-related complications. Occipital nerve blocks may constitute a safe and effective component of multimodal analgesia in this population. Full article
(This article belongs to the Special Issue State-of-Art in Pediatric Anesthesia)
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