Anesthesiology

The First Opioid-Prescribing Guidelines for Children Who Require Surgery
The First Opioid-Prescribing Guidelines for Children Who Require Surgery 1024 573 Lauren Dembeck

Providers should recognize the risks of opioids, maximize nonopioid regimens, and educate families appropriately. The first opioid-prescribing guidelines to address the unique needs of children who require surgery have been published by an expert panel in JAMA Surgery. The new guidelines aim to help health care professionals caring for children and adolescents in the perioperative…

Regional Anesthesia Dramatically Reduces Opioid Use After Limb Lengthening and Reconstructive Surgeries
Regional Anesthesia Dramatically Reduces Opioid Use After Limb Lengthening and Reconstructive Surgeries 1024 584 Katie Brind'Amour, PhD, MS, CHES

The peripheral catheter approach to postoperative pain management may also shorten length of stay. When clinicians in the Department of Anesthesiology and Pain Medicine at Nationwide Children’s Hospital first proposed the use of regional anesthesia for the patients of Christopher Iobst, MD, he was resistant to the idea. As an orthopedic surgeon specializing in limb lengthening and…

Pushing the Boundaries of Regional Anesthesia for Complex Urological Surgery
Pushing the Boundaries of Regional Anesthesia for Complex Urological Surgery 150 150 Katie Brind'Amour, PhD, MS, CHES

Physician-researchers extend the possibilities for regional anesthesia using combined spinal/caudal catheter anesthesia, allowing even complex, time-consuming pediatric urological surgeries to be completed without general anesthesia. In an effort to extend more regional anesthetic options to children undergoing urological procedures — and to obviate concerns about airway safety and theoretical neurocognitive effects of general anesthesia (GA)…

Managing Pain in an Era of Opioid Abuse
Managing Pain in an Era of Opioid Abuse 1024 575 Abbie Miller
A black-and-white image of an adolescent White boy, a young Black girl, an adolescent White girl, a Black teen boy, and a young White mom and her infant, all in a row across the screen, all in white shirts, and all with solemn expressions.

Managing pain is complicated. Not that long ago, perhaps 50 years or so, pain was understood to be a multidisciplinary issue requiring many different approaches. Doctors would recommend lifestyle changes, complementary therapies and medications to treat chronic pain. Then something changed. Opioids began being marketed as “nonaddictive.” Pain became the “5th vital sign,” and physicians…

Femoral Nerve Blockade May Reduce Need for Intravenous Opioids
Femoral Nerve Blockade May Reduce Need for Intravenous Opioids 150 150 Mary Bates, PhD

Researchers find no differences in postoperative pain measures for patients receiving intravenous opioids and those receiving regional anesthetic. Femur fractures often require surgical fixes and can be quite painful. Although traditionally treated with intravenous opioids, regional anesthesia may offer an alternative option. In a new study, published in the Journal of Pain Research, researchers evaluated the…

Can Spinal Replace General Anesthesia in Pediatric Urology Patients?
Can Spinal Replace General Anesthesia in Pediatric Urology Patients? 150 150 Jeb Phillips

Spinal anesthesia offers a viable low-risk alternative to general anesthesia for a wide range of pediatric procedures, particularly for urology patients. As research continues to illuminate the possibility of neurotoxic effects from general anesthesia in pediatric patients, surgeons and anesthesiologists at Nationwide Children’s Hospital have already sought out an alternative among children 2 years of…

Methadone Weaning: The Role of the Pharmacist
Methadone Weaning: The Role of the Pharmacist 150 150 Abbie Miller

Pharmacist-led methadone tapers are improving outcomes and reducing practice variation in pediatric intensive care units. In neonatal and pediatric intensive care units, opioid use is necessary for controlling pain and as an adjunct to sedation during mechanical ventilation. However, after as few as five days of use, approximately 50 percent of patients will experience withdrawal…

Advancing Pediatric Anesthesiology Through Research
Advancing Pediatric Anesthesiology Through Research 150 150 Joseph Tobias, MD

Pediatric anesthesiology research is a relatively new phenomenon. But one clinician-scientist believes it is the key to bringing the field into the “big leagues” of evidence-based medicine. Over the past 30 years, the field of pediatric anesthesiology has expanded with the recognition of the need for specialized training, the development of fellowship programs and, most…

Getting to the Point: Are Safety Needles Really Safe?
Getting to the Point: Are Safety Needles Really Safe? 150 150 Kelli Whitlock Burton

Sharp hypodermic needles are, as the name implies, sharp. Just ask the nearly 400,000 U.S. health care workers who are accidentally pricked each year. Most needle sticks aren’t serious, but the potential for exposure to bloodborne diseases has led many hospitals to discontinue the use of sharp needles in certain areas, including the operating room.…

InSight: Working Up the Nerve
InSight: Working Up the Nerve 150 150 Katie Brind'Amour, PhD, MS, CHES

Using regional anesthesia to numb nerves reduces pain and speeds recovery in pediatric orthopedic surgery. Ultrasound-guided regional anesthesia has been used in adult patients for more than a decade but is now being used more regularly in pediatric patients, especially for orthopedic procedures. Femoral nerve block, in which the femoral nerve is numbed, is among…