Retrospective study comparing outcomes of multimodal epidural and erector spinae catheter pain protocols after pectus surgery.

Introduction: There are no optimal postoperative analgesia regimens for Nuss procedures. We compared the effectiveness of thoracic epidurals (EPI) and novel ambulatory erector spinae plane (ESP) catheters as part of multimodal pain protocols after Nuss surgery.

Methods: Data on demographics, comorbidities, perioperative details, length of stay (LOS), in hospital and post discharge pain/opioid use, side effects, and emergency department (ED) visits were collected retrospectively in children who underwent Nuss repair with EPI (N = 114) and ESP protocols (N = 97).

Impact of Instituting General Anesthesia on Oral Sedation Care in a Tertiary Care Pediatric Dental Clinic.

Tertiary pediatric medical centers disproportionately care for low-income, underserved children with significant dental needs. Long wait times for hospital operating room treatment increase tooth loss rather than restoration. Oral sedation has commonly been provided to avoid the long waits for operating room treatment.

Optical tissue clearing in combination with perfusion and immunofluorescence for placental vascular imaging.

Imaging of placental tissues is a difficult task, because of specific for this organ complex multicellular and 3D tissue structure. The tissue clearing systems (X-CLARITY) system is a valuable tool for the examining the expression of molecular pathways in whole tissues and organs, originally developed for brain imaging.In the present report, we utilized this technology for the examination of placental vasculature and protein expression in perfused human placental tissue.

CYP2D6 pharmacogenetic and oxycodone pharmacokinetic association study in pediatric surgical patients.

Aim: Oxycodone is partly metabolized to the active metabolite oxymorphone by hepatic CYP2D6 in the liver. Significant genetic variability in CYP2D6 activity affects oxymorphone formation. This study aimed to associate CYP2D6 genotype and oxycodone's metabolism.

Anesthesia and analgesia for pectus excavatum surgery.

The technique of choice for surgical correction of pectus excavatum is the Nuss procedure, a minimally invasive technique in which rigid metal bars are placed transthoracically beneath the sternum and costal cartilages until permanent remodeling of the chest wall has occurred. Intraoperatively, anesthesia focuses on three areas: the potential for catastrophic blood loss caused by perforation of large capacitance vessels and the heart, the potential for malignant arrhythmias, and the consequences of bilateral iatrogenic pneumothoraces. Postoperatively, analgesia is institutionally dependent and controversial, based on usage and type of regional anesthesia.

Novel real-time feedback and integrated simulation model for teaching and evaluating ultrasound-guided regional anesthesia skills in pediatric anesthesia trainees.

Objectives: To assess, teach, and improve core competencies and skills sets associated with ultrasound-guided regional anesthesia (UGRA) of pediatric anesthesia trainees.

Aim: To effectively assess and improve UGRA-associated cognitive and technical skills and proficiency of pediatric anesthesia trainees using simulators and real-time feedback.

Background: Ultrasound usage has been increasingly adopted by anesthesiologists to perform regional anesthesia.

Competency and professionalism in medicine.

Background: In this article some definitions of competency and professionalism will be discussed, and an overview of existing methods that assess competency and professionalism in anaesthesia resident doctors (residents) is provided. In addition, we will discuss how progression to professionalism, education in anaesthesiology and other medical specialties may be improved using the adult skill acquisition model. The goal of this paper is to refine the definitions of professionalism and competency, and to propose a new approach to medical education.