PedsAnesthesiaNet - User contributions [en]

Ex utero intrapartum treatment (EXIT)

2026-05-14T14:36:49Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubs.asahq.org/anesthesiology/article/141/6/1139/141985/Ex-Utero-Intrapartum-Intubation-for-Giant-Fetal Ex Utero Intrapartum Intubation for Giant Fetal Neck Mass ]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

https://paperpile.com/shared/Fetal-Surgery-frUbXc7jDDAKsen4GGTXtsg

Lau, C.T., Kan, A., Shek, N. et al. Is congenital pulmonary airway malformation really a rare disease? Result of a prospective registry with universal antenatal screening program. Pediatr Surg Int 33, 105-108 (2017)

Kunisaki SM, Saito JM, Fallat ME, et al. Current operative management of congenital lobar emphysema in children: A report from the Midwest Pediatric Surgery Consortium. J Pediat Surg 2019;54:1138-42

Kunisaki SM, Powelson IA, Haydar B, et al. Thoracoscopic vs open lobectomy in infants and young children with congenital lung malformations. JAm Coll Surg
2014;218:261-70

Kunisaki SM, Saito JM, Fallat ME, et al. Fetal risk stratification and outcomes in children with prenatally diagnosed lung malformations: results from a multi-institutional research collaborative. Ann Surg 2020;

[https://pubmed.ncbi.nlm.nih.gov/30363271/ Chaos syndrome]

Ex utero intrapartum treatment (EXIT)

2026-05-14T14:35:50Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubs.asahq.org/anesthesiology/article/141/6/1139/141985/Ex-Utero-Intrapartum-Intubation-for-Giant-Fetal Ex Utero Intrapartum Intubation for Giant Fetal Neck Mass ]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

https://paperpile.com/shared/Fetal-Surgery-frUbXc7jDDAKsen4GGTXtsg

Lau, C.T., Kan, A., Shek, N. et al. Is congenital pulmonary airway malformation really a rare disease? Result of a prospective registry with universal antenatal screening program. Pediatr Surg Int 33, 105-108 (2017)

Kunisaki SM, Saito JM, Fallat ME, et al. Current operative management of congenital lobar emphysema in children: A report from the Midwest Pediatric Surgery Consortium. J Pediat Surg 2019;54:1138-42

Kunisaki SM, Powelson IA, Haydar B, et al. Thoracoscopic vs open lobectomy in infants and young children with congenital lung malformations. JAm Coll Surg
2014;218:261-70

Kunisaki SM, Saito JM, Fallat ME, et al. Fetal risk stratification and outcomes in children with prenatally diagnosed lung malformations: results from a multi-institutional research collaborative. Ann Surg 2020;

[https://pubmed.ncbi.nlm.nih.gov/30363271/ Chaos syndrome]

Ex utero intrapartum treatment (EXIT)

2026-05-14T14:29:54Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubs.asahq.org/anesthesiology/article/141/6/1139/141985/Ex-Utero-Intrapartum-Intubation-for-Giant-Fetal Ex Utero Intrapartum Intubation for Giant Fetal Neck Mass ]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

https://paperpile.com/shared/Fetal-Surgery-frUbXc7jDDAKsen4GGTXtsg

Lau, C.T., Kan, A., Shek, N. et al. Is congenital pulmonary airway malformation really a rare disease? Result of a prospective registry with universal antenatal screening program. Pediatr Surg Int 33, 105-108 (2017)

Kunisaki SM, Saito JM, Fallat ME, et al. Current operative management of congenital lobar emphysema in children: A report from the Midwest Pediatric Surgery Consortium. J Pediat Surg 2019;54:1138-42

Kunisaki SM, Powelson IA, Haydar B, et al. Thoracoscopic vs open lobectomy in infants and young children with congenital lung malformations. JAm Coll Surg
2014;218:261-70

Kunisaki SM, Saito JM, Fallat ME, et al. Fetal risk stratification and outcomes in children with prenatally diagnosed lung malformations: results from a multi-institutional research collaborative. Ann Surg 2020;

[https://pubmed.ncbi.nlm.nih.gov/30363271/ Chaos syndrome]

Ex utero intrapartum treatment (EXIT)

2026-05-14T14:29:34Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubs.asahq.org/anesthesiology/article/141/6/1139/141985/Ex-Utero-Intrapartum-Intubation-for-Giant-Fetal Ex Utero Intrapartum Intubation for Giant Fetal Neck Mass ]

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

https://paperpile.com/shared/Fetal-Surgery-frUbXc7jDDAKsen4GGTXtsg

Lau, C.T., Kan, A., Shek, N. et al. Is congenital pulmonary airway malformation really a rare disease? Result of a prospective registry with universal antenatal screening program. Pediatr Surg Int 33, 105-108 (2017)

Kunisaki SM, Saito JM, Fallat ME, et al. Current operative management of congenital lobar emphysema in children: A report from the Midwest Pediatric Surgery Consortium. J Pediat Surg 2019;54:1138-42

Kunisaki SM, Powelson IA, Haydar B, et al. Thoracoscopic vs open lobectomy in infants and young children with congenital lung malformations. JAm Coll Surg
2014;218:261-70

Kunisaki SM, Saito JM, Fallat ME, et al. Fetal risk stratification and outcomes in children with prenatally diagnosed lung malformations: results from a multi-institutional research collaborative. Ann Surg 2020;

[https://pubmed.ncbi.nlm.nih.gov/30363271/ Chaos syndrome]

Ex utero intrapartum treatment (EXIT)

2026-05-14T11:44:42Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubs.asahq.org/anesthesiology/article/141/6/1139/141985/Ex-Utero-Intrapartum-Intubation-for-Giant-Fetal Ex Utero Intrapartum Intubation for Giant Fetal Neck Mass ]

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

https://paperpile.com/shared/Fetal-Surgery-frUbXc7jDDAKsen4GGTXtsg

Lau, C.T., Kan, A., Shek, N. et al. Is congenital pulmonary airway malformation really a rare disease? Result of a prospective registry with universal antenatal screening program. Pediatr Surg Int 33, 105-108 (2017)

Kunisaki SM, Saito JM, Fallat ME, et al. Current operative management of congenital lobar emphysema in children: A report from the Midwest Pediatric Surgery Consortium. J Pediat Surg 2019;54:1138-42

Kunisaki SM, Powelson IA, Haydar B, et al. Thoracoscopic vs open lobectomy in infants and young children with congenital lung malformations. JAm Coll Surg
2014;218:261-70

Kunisaki SM, Saito JM, Fallat ME, et al. Fetal risk stratification and outcomes in children with prenatally diagnosed lung malformations: results from a multi-institutional research collaborative. Ann Surg 2020;

[https://pubmed.ncbi.nlm.nih.gov/30363271/ Chaos syndrome]

Ex utero intrapartum treatment (EXIT)

2026-05-14T11:41:38Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

[https://pubs.asahq.org/anesthesiology/article/141/6/1139/141985/Ex-Utero-Intrapartum-Intubation-for-Giant-Fetal Ex Utero Intrapartum Intubation for Giant Fetal Neck Mass ]

[https://pubmed.ncbi.nlm.nih.gov/16616314/ The EXIT procedure: principles, pitfalls, and progress]

[https://pubmed.ncbi.nlm.nih.gov/34638008/ Ex utero intrapartum technique (EXIT): Indications, procedure methods and materno-fetal complications - A literature review]

[https://pubmed.ncbi.nlm.nih.gov/19396506/ Obstetric hemorrhage during an EXIT procedure for severe fetal airway obstruction]

[https://pubmed.ncbi.nlm.nih.gov/30104819/ Role of anesthesiologist in ex utero intrapartum treatment procedure: A case and review of anesthetic management]

https://paperpile.com/shared/Fetal-Surgery-frUbXc7jDDAKsen4GGTXtsg

Lau, C.T., Kan, A., Shek, N. et al. Is congenital pulmonary airway malformation really a rare disease? Result of a prospective registry with universal antenatal screening program. Pediatr Surg Int 33, 105-108 (2017)

Kunisaki SM, Saito JM, Fallat ME, et al. Current operative management of congenital lobar emphysema in children: A report from the Midwest Pediatric Surgery Consortium. J Pediat Surg 2019;54:1138-42

Kunisaki SM, Powelson IA, Haydar B, et al. Thoracoscopic vs open lobectomy in infants and young children with congenital lung malformations. JAm Coll Surg
2014;218:261-70

Kunisaki SM, Saito JM, Fallat ME, et al. Fetal risk stratification and outcomes in children with prenatally diagnosed lung malformations: results from a multi-institutional research collaborative. Ann Surg 2020;

Ex utero intrapartum treatment (EXIT)

2026-05-14T11:28:33Z

WikiSysop:

Early Mobilization

2026-05-13T14:05:35Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/40279266/ PACU Up!: Feasibility of an Early Mobilization Program for Children After Surgery and Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/33742678/ Mobilization Started Within 2 Hours After Abdominal Surgery Improves Peripheral and Arterial Oxygenation: A Single-Center Randomized Controlled Trial]

[https://pubmed.ncbi.nlm.nih.gov/34201003/ Impact of early mobilization on recovery after major head and neck surgery with free flap reconstruction]

[https://pubmed.ncbi.nlm.nih.gov/35607804/ Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case-control study]

[https://www.sccm.org/iculiberation Society for Critical Care Medicine. ICU liberation. Accessed 07/14/2023]

Advanced Ventilation

2026-05-13T14:04:35Z

WikiSysop:

{{Stub Notice}}

[https://youtu.be/UyewbZmL9xQ Open Pediatrics: Therapies When Conventional Ventilation Fails]

[https://www.bjanaesthesia.org/article/S0007-0912(19)30849-9/fulltext Emergency front of neck access in children: a new learning approach in a rabbit model]

[https://www.chop.edu/clinical-pathway/sedation-analgesia-picu-mechanically-ventilated-patient-clinical-pathway PICU Clinical Pathway for Sedation/Analgesia in the Invasively Mechanically Ventilated Patient]

Fan E, Zakhary B, Amaral A, et al. Liberation from Mechanical Ventilation in Critically Ill Adults. An Official ATS/ACCP Clinical Practice Guideline. Ann Am Thorac Soc. Mar 2017;14(3):441-443. doi:10.1513/AnnalsATS.201612-993CME

Abu-Sultaneh S, Iyer NP, Fernández A, et al. Operational Definitions Related to Pediatric Ventilator Liberation. Chest. May 2023;163(5):1130-1143. doi:10.1016/j.chest.2022.12.010

Abu-Sultaneh S, Iyer NP, Fernández A, et al. Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Document. Am J Respir Crit Care Med. Jan 1 2023;207(1):17-28. doi:10.1164/rccm.202204-0795SO

Curley MA, Wypij D, Watson RS, et al. Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. Jama. Jan 27 2015;313(4):379-89. doi:10.1001/jama.2014.18399

Blackwood B, Tume LN, Morris KP, et al. Effect of a Sedation and Ventilator Liberation Protocol vs Usual Care on Duration of Invasive Mechanical Ventilation in Pediatric Intensive Care Units: A Randomized Clinical Trial. Jama. Aug 3 2021;326(5):401-410. doi:10.1001/jama.2021.10296

Lavizzari, A, Zannin, E, Klotz, D, Dassios, T, Roehr, CC. State of the art on neonatal noninvasive respiratory support: how physiological and technological principles explain the clinical outcomes. Pediatr Pulmonol. 2023; 58: 2442-2455. doi:10.1002/ppul.26561

King BC, Gandhi BB, Jackson A, Katakam L, Pammi M, Suresh G. Mask versus Prongs for Nasal Continuous Positive Airway Pressure in Preterm Infants: A Systematic Review and Meta-Analysis. Neonatology. 2019;116(2):100-114. doi:10.1159/000496462

Yoder BA, Manley B, Collins C, Ives K, Kugelman A, Lavizzari A, McQueen M. Consensus approach to nasal high-flow therapy in neonates. Journal of Perinatology. 2017/07/01 2017;37(7):809-813. doi:10.1038/jp.2017.24

Iranpour R, Armanian AM, Abedi AR, Farajzadegan Z. Nasal high-frequency oscillatory ventilation (nHFOV) versus nasal continuous positive airway pressure (NCPAP) as an initial therapy for respiratory distress syndrome (RDS) in preterm and near-term infants. BMJ Paediatr Open. 2019;3(1):e000443. doi:10.1136/bmjpo-2019-000443

Gálvez JA, Acquah S, Ahumada L, et al. Hypoxemia, Bradycardia, and Multiple Laryngoscopy Attempts during Anesthetic Induction in Infants: A Single-center, Retrospective Study. Anesthesiology. Oct 2019;131(4):830-839. doi:10.1097/aln.0000000000002847

Fiadjoe J, Nishisaki A. Normal and difficult airways in children: "What's New"-Current evidence. Paediatric anaesthesia. Dec 23 2019;doi:10.1111/pan.13798

Fiadjoe JE, Litman RS. Oxygen supplementation during prolonged tracheal intubation should be the standard of care. British journal of anaesthesia. Oct 2016;117(4):417-418. doi:10.1093/bja/aew303

Polin RA, Carlo WA. Surfactant replacement therapy for preterm and term neonates with respiratory distress. Pediatrics. Jan 2014;133(1):156-63. doi:10.1542/peds.2013-3443

Sweet DG, Carnielli VP, Greisen G, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update. Neonatology. 2023;120(1):3-23. doi:10.1159/000528914

Ekhaguere OA, Mairami AB, Kirpalani H. Risk and benefits of Bubble Continuous Positive Airway Pressure for neonatal and childhood respiratory diseases in Low- and Middle-Income countries. Paediatr Respir Rev. Feb 2019;29:31-36. doi:10.1016/j.prrv.2018.04.004

[https://pubmed.ncbi.nlm.nih.gov/38097106/ Exerted force on the face mask in preterm infants at birth is associated with apnoea and bradycardia]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2024/10000/end_tidal_control_versus_manual_control_of.17.aspx End-Tidal Control Versus Manual Control of Inhalational Anesthesia Delivery: A Randomized Controlled Noninferiority Trial]

[https://www.bjaed.org/article/S2058-5349(24)00122-7/fulltext Causes and management of impaired gas exchange in critically ill patients]

[https://link.springer.com/content/pdf/10.1007/s44253-024-00047-0.pdf Flow trigger setting in mechanically ventilated neonates, children and adults: a scoping review]

Meyers M, Rodrigues N, Ari A. High-frequency oscillatory ventilation: a narrative review. Can J Respir Ther. 2019 May; 55: 40-46. PMID: 31297448

Wong R, Deakers T, Hotz J, Khemani RG, Ross PA, Newth CJ. Volume and pressure delivery during pediatric high-frequency oscillatory ventilation. Pediatr Crit Care Med. 2017 Apr; 18(4): e189-e194. PMID: 28212162

[https://www.bjanaesthesia.org/article/S0007-0912(25)00558-6/fulltext Efficacy of a lung recruitment manoeuvre in children undergoing general anaesthesia with a supraglottic airway]

Junod AF. Oxygen free radicals and lungs. Intensive Care Med. 1989;15 Suppl 1:S21-23. PMID: 2723243.

2. McIlroy DR, Shotwell MS, Lopez MG, Vaughn MT, Olsen JS, Hennessy C, Wanderer JP, Semler MS, Rice TW, Kheterpal S, Billings FT 4th; Multicenter Perioperative Outcomes Group. Oxygen administration during surgery and postoperative organ injury: observational cohort study. BMJ. 2022 Nov 30;379:e070941. PMID: 36450405

3. Balcarcel DR, Coates BM, Chong G, Sanchez-Pinto LN. Excessive Oxygen Supplementation in the First Day of Mechanical Ventilation Is Associated With Multiple Organ Dysfunction and Death in Critically Ill Children. Pediatr Crit Care Med. 2022 Feb 1;23(2):89-98. PMID: 35119429

4. Billings FT 4th, McIlroy DR, Shotwell MS, Lopez MG, Vaughn MT, Morse JL, Hennessey CJ, Wanderer JP, Semler MW, Rice TW, Wunsch H, Kheterpal S. Determinants and Practice Variability of Oxygen Administration during Surgery in the United States: A Retrospective Cohort Study. Anesthesiology. 2024 Sep 1;141(3):511-523. PMID: 38759157

5. Tian YQ, Wei W, Liu YQ, Xiao YY, Liu KJ, Li JH, Peng XM. Lung Ultrasound Evaluation of the Impact of Inspired Oxygen Fraction on Atelectasis During Induction of General Anesthesia in Pediatric Patients: A Randomized Controlled Trial. Shock. 2025 Dec 30. PMID: 41697232.

6. Wang Q, Li Y, Zhao K, Zhang J, Zhou J. Optimizing perioperative lung protection strategies for reducing postoperative respiratory complications in pediatric patients: a narrative review. Transl Pediatr. 2024 Nov 30;13(11):2043-2058. PMID: 39649647.

7. Zhang C, Xu F, Li W, Tong X, Xia R, Wang W, Du J, Shi X. Driving Pressure-Guided Individualized Positive End-Expiratory Pressure in Abdominal Surgery: A Randomized Controlled Trial. Anesth Analg. 2021 Nov 1;133(5):1197-1205. PMID: 34125080.

8. Balmaks E, Kentish SE, Seglenieks R, Lee JH, McGain F. Financial and environmental impacts of using oxygen rather than air as a ventilator drive gas. Anaesthesia. 2022 Dec;77(12):1451-1452. PMID: 36039020.

[https://journals.lww.com/anesthesiology/abstract/9900/mechanical_power_and_energy_in_invasively.1006.aspx Mechanical power and energy in invasively ventilated newborn infants]

Advanced Ventilation

2026-05-13T14:01:45Z

WikiSysop:

{{Stub Notice}}

[https://youtu.be/UyewbZmL9xQ Open Pediatrics: Therapies When Conventional Ventilation Fails]

[https://www.bjanaesthesia.org/article/S0007-0912(19)30849-9/fulltext Emergency front of neck access in children: a new learning approach in a rabbit model]

[https://www.chop.edu/clinical-pathway/sedation-analgesia-picu-mechanically-ventilated-patient-clinical-pathway PICU Clinical Pathway for Sedation/Analgesia in the Invasively Mechanically Ventilated Patient]

Society for Critical Care Medicine. ICU liberation. Accessed 07/14/2023, https://www.sccm.org/iculiberation

Fan E, Zakhary B, Amaral A, et al. Liberation from Mechanical Ventilation in Critically Ill Adults. An Official ATS/ACCP Clinical Practice Guideline. Ann Am Thorac Soc. Mar 2017;14(3):441-443. doi:10.1513/AnnalsATS.201612-993CME

Abu-Sultaneh S, Iyer NP, Fernández A, et al. Operational Definitions Related to Pediatric Ventilator Liberation. Chest. May 2023;163(5):1130-1143. doi:10.1016/j.chest.2022.12.010

Abu-Sultaneh S, Iyer NP, Fernández A, et al. Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Document. Am J Respir Crit Care Med. Jan 1 2023;207(1):17-28. doi:10.1164/rccm.202204-0795SO

Curley MA, Wypij D, Watson RS, et al. Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. Jama. Jan 27 2015;313(4):379-89. doi:10.1001/jama.2014.18399

Blackwood B, Tume LN, Morris KP, et al. Effect of a Sedation and Ventilator Liberation Protocol vs Usual Care on Duration of Invasive Mechanical Ventilation in Pediatric Intensive Care Units: A Randomized Clinical Trial. Jama. Aug 3 2021;326(5):401-410. doi:10.1001/jama.2021.10296

Lavizzari, A, Zannin, E, Klotz, D, Dassios, T, Roehr, CC. State of the art on neonatal noninvasive respiratory support: how physiological and technological principles explain the clinical outcomes. Pediatr Pulmonol. 2023; 58: 2442-2455. doi:10.1002/ppul.26561

King BC, Gandhi BB, Jackson A, Katakam L, Pammi M, Suresh G. Mask versus Prongs for Nasal Continuous Positive Airway Pressure in Preterm Infants: A Systematic Review and Meta-Analysis. Neonatology. 2019;116(2):100-114. doi:10.1159/000496462

Yoder BA, Manley B, Collins C, Ives K, Kugelman A, Lavizzari A, McQueen M. Consensus approach to nasal high-flow therapy in neonates. Journal of Perinatology. 2017/07/01 2017;37(7):809-813. doi:10.1038/jp.2017.24

Iranpour R, Armanian AM, Abedi AR, Farajzadegan Z. Nasal high-frequency oscillatory ventilation (nHFOV) versus nasal continuous positive airway pressure (NCPAP) as an initial therapy for respiratory distress syndrome (RDS) in preterm and near-term infants. BMJ Paediatr Open. 2019;3(1):e000443. doi:10.1136/bmjpo-2019-000443

Gálvez JA, Acquah S, Ahumada L, et al. Hypoxemia, Bradycardia, and Multiple Laryngoscopy Attempts during Anesthetic Induction in Infants: A Single-center, Retrospective Study. Anesthesiology. Oct 2019;131(4):830-839. doi:10.1097/aln.0000000000002847

Fiadjoe J, Nishisaki A. Normal and difficult airways in children: "What's New"-Current evidence. Paediatric anaesthesia. Dec 23 2019;doi:10.1111/pan.13798

Fiadjoe JE, Litman RS. Oxygen supplementation during prolonged tracheal intubation should be the standard of care. British journal of anaesthesia. Oct 2016;117(4):417-418. doi:10.1093/bja/aew303

Polin RA, Carlo WA. Surfactant replacement therapy for preterm and term neonates with respiratory distress. Pediatrics. Jan 2014;133(1):156-63. doi:10.1542/peds.2013-3443

Sweet DG, Carnielli VP, Greisen G, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update. Neonatology. 2023;120(1):3-23. doi:10.1159/000528914

Ekhaguere OA, Mairami AB, Kirpalani H. Risk and benefits of Bubble Continuous Positive Airway Pressure for neonatal and childhood respiratory diseases in Low- and Middle-Income countries. Paediatr Respir Rev. Feb 2019;29:31-36. doi:10.1016/j.prrv.2018.04.004

[https://pubmed.ncbi.nlm.nih.gov/38097106/ Exerted force on the face mask in preterm infants at birth is associated with apnoea and bradycardia]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2024/10000/end_tidal_control_versus_manual_control_of.17.aspx End-Tidal Control Versus Manual Control of Inhalational Anesthesia Delivery: A Randomized Controlled Noninferiority Trial]

[https://www.bjaed.org/article/S2058-5349(24)00122-7/fulltext Causes and management of impaired gas exchange in critically ill patients]

[https://link.springer.com/content/pdf/10.1007/s44253-024-00047-0.pdf Flow trigger setting in mechanically ventilated neonates, children and adults: a scoping review]

Meyers M, Rodrigues N, Ari A. High-frequency oscillatory ventilation: a narrative review. Can J Respir Ther. 2019 May; 55: 40-46. PMID: 31297448

Wong R, Deakers T, Hotz J, Khemani RG, Ross PA, Newth CJ. Volume and pressure delivery during pediatric high-frequency oscillatory ventilation. Pediatr Crit Care Med. 2017 Apr; 18(4): e189-e194. PMID: 28212162

[https://www.bjanaesthesia.org/article/S0007-0912(25)00558-6/fulltext Efficacy of a lung recruitment manoeuvre in children undergoing general anaesthesia with a supraglottic airway]

Junod AF. Oxygen free radicals and lungs. Intensive Care Med. 1989;15 Suppl 1:S21-23. PMID: 2723243.

2. McIlroy DR, Shotwell MS, Lopez MG, Vaughn MT, Olsen JS, Hennessy C, Wanderer JP, Semler MS, Rice TW, Kheterpal S, Billings FT 4th; Multicenter Perioperative Outcomes Group. Oxygen administration during surgery and postoperative organ injury: observational cohort study. BMJ. 2022 Nov 30;379:e070941. PMID: 36450405

3. Balcarcel DR, Coates BM, Chong G, Sanchez-Pinto LN. Excessive Oxygen Supplementation in the First Day of Mechanical Ventilation Is Associated With Multiple Organ Dysfunction and Death in Critically Ill Children. Pediatr Crit Care Med. 2022 Feb 1;23(2):89-98. PMID: 35119429

4. Billings FT 4th, McIlroy DR, Shotwell MS, Lopez MG, Vaughn MT, Morse JL, Hennessey CJ, Wanderer JP, Semler MW, Rice TW, Wunsch H, Kheterpal S. Determinants and Practice Variability of Oxygen Administration during Surgery in the United States: A Retrospective Cohort Study. Anesthesiology. 2024 Sep 1;141(3):511-523. PMID: 38759157

5. Tian YQ, Wei W, Liu YQ, Xiao YY, Liu KJ, Li JH, Peng XM. Lung Ultrasound Evaluation of the Impact of Inspired Oxygen Fraction on Atelectasis During Induction of General Anesthesia in Pediatric Patients: A Randomized Controlled Trial. Shock. 2025 Dec 30. PMID: 41697232.

6. Wang Q, Li Y, Zhao K, Zhang J, Zhou J. Optimizing perioperative lung protection strategies for reducing postoperative respiratory complications in pediatric patients: a narrative review. Transl Pediatr. 2024 Nov 30;13(11):2043-2058. PMID: 39649647.

7. Zhang C, Xu F, Li W, Tong X, Xia R, Wang W, Du J, Shi X. Driving Pressure-Guided Individualized Positive End-Expiratory Pressure in Abdominal Surgery: A Randomized Controlled Trial. Anesth Analg. 2021 Nov 1;133(5):1197-1205. PMID: 34125080.

8. Balmaks E, Kentish SE, Seglenieks R, Lee JH, McGain F. Financial and environmental impacts of using oxygen rather than air as a ventilator drive gas. Anaesthesia. 2022 Dec;77(12):1451-1452. PMID: 36039020.

[https://journals.lww.com/anesthesiology/abstract/9900/mechanical_power_and_energy_in_invasively.1006.aspx Mechanical power and energy in invasively ventilated newborn infants]

The Anesthesia Workforce

2026-05-12T16:00:29Z

WikiSysop:

{{Stub Notice}}

The Anesthesia Workforce

[https://pubmed.ncbi.nlm.nih.gov/38884582/ Closing the Chasm: Understanding and Addressing the Anesthesia Workforce Supply and Demand Imbalance]

[https://pubmed.ncbi.nlm.nih.gov/29116973/ The Pediatric Anesthesiology Workforce: Projecting Supply and Trends 2015-2035. Anesthesia and analgesia]

[https://pubmed.ncbi.nlm.nih.gov/35180170/ The Practice of Pediatric Cardiac Anesthesiology in the United States. Anesthesia and analgesia]

[https://pubmed.ncbi.nlm.nih.gov/35671023/ Global pediatric surgery and anesthesia inequities: how do we have a global effort? Current opinion in anaesthesiology]

[https://pedsanesthesia.net/wiki/images/a/a7/Numb_and_Number.pdf Numb and Number: Once a Hot Specialty, Anesthesiology Cools As Insurers Scale Back ---Health-Care Workers Find Fewer Jobs, Lower Pay In Era of Cost-Cutting --- Working Harder for $100,000. The Wall Street Journal: Dow Jones & Company; 1995]]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2013/06000/possible_leading_indicator_for_decreased_demand.33.aspx Possible Leading Indicator for Decreased Demand for Anesthesiologists]

[https://pubmed.ncbi.nlm.nih.gov/38264926/ Where have all the pediatric anesthesiology fellows gone in the USA? Anesthesiology fellowship trends]

[https://pubmed.ncbi.nlm.nih.gov/37930155/ U.S. Attending Anesthesiologist Burnout in the Postpandemic Era]

[https://pubmed.ncbi.nlm.nih.gov/35016664/ Motivation and personality factors of Generation Z high school students aspiring to study human medicine]

[https://pubmed.ncbi.nlm.nih.gov/38884582/ Closing the Chasm: Understanding and Addressing the Anesthesia Workforce Supply and Demand Imbalance]

[https://pubmed.ncbi.nlm.nih.gov/34074883/ National trends in nonoperating room anesthesia: procedures, facilities, and patient characteristics]

[https://pubmed.ncbi.nlm.nih.gov/29116973/ The Pediatric Anesthesiology Workforce: Projecting Supply and Trends 2015-2035. Anesthesia and analgesia]

[https://pubmed.ncbi.nlm.nih.gov/35180170/ The Practice of Pediatric Cardiac Anesthesiology in the United States]

[https://pubmed.ncbi.nlm.nih.gov/35671023/ Global pediatric surgery and anesthesia inequities: how do we have a global effort?]

[https://pubmed.ncbi.nlm.nih.gov/37656462/ Shifts in the Hospital Care of Children in the US—A Health Equity Challenge]

[https://pubmed.ncbi.nlm.nih.gov/37656457/ Pediatric Hospitalizations at Rural and Urban Teaching and Nonteaching Hospitals in the US, 2009-2019]

[https://pubmed.ncbi.nlm.nih.gov/29116973/ The Pediatric Anesthesiology Workforce: Projecting Supply and Trends 2015-2035]

[https://pubmed.ncbi.nlm.nih.gov/39688202/ The Pediatric Anesthesiology Workforce in the United States: How to Curb the Crisis?]

[https://pubmed.ncbi.nlm.nih.gov/39644206 Understanding Pediatric Anesthesiology Fellowship Interest: A National Survey of the Resident Experience]

[https://pubmed.ncbi.nlm.nih.gov/32777147/ Epidemiology of Pediatric Surgery in the United States]

[https://pubmed.ncbi.nlm.nih.gov/9390577/ Subspecialty training in pediatric anesthesiology: what does it mean?]

[https://pubmed.ncbi.nlm.nih.gov/31743202/ Pediatric Anesthesiology Fellowship Positions: Is There a Mismatch?]

[https://pubmed.ncbi.nlm.nih.gov/38264926/ Where have all the pediatric anesthesiology fellows gone in the USA?]

[https://pubmed.ncbi.nlm.nih.gov/39467721/ The impact of current pediatric anesthesiology fellows shortfall on freestanding children’s hospitals and practices]

[https://pubmed.ncbi.nlm.nih.gov/35777829/ A Consensus-Driven Approach to Redesigning Graduate Medical Education: The Pediatric Anesthesiology Delphi Study]

[https://pubmed.ncbi.nlm.nih.gov/35773224/ A Consensus-Driven Revision of the Accreditation Council for Graduate Medical Education Case Log System: Pediatric Anesthesiology Fellowship Education]

[https://pubmed.ncbi.nlm.nih.gov/40846559/ Supply and Demand: Pediatric Surgical Specialties Fellowship Match Trends]

[https://journals.lww.com/anesthesiologyopen/fulltext/2026/01000/american_society_of_anesthesiologists_statement_on.1.aspx American Society of Anesthesiologists Statement on Anesthesiologist-led Care]

Carullo P, Khan S, Nause-Osthoff R, et al. Understanding Pediatric Anesthesiology Fellowship Interest: A National Survey of the Resident Experience. Paediatric anaesthesia 2025;35(3):223–231. (In eng). DOI: 10.1111/pan.15049.

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/reviewing_current_trends__private_equity_in.25.aspx/ Reviewing Current Trends: Private Equity in Anesthesiology]

Emergence Delirium

2026-05-12T15:44:51Z

WikiSysop:

{{Stub Notice}}

Emergence Agitation/Delirium

[https://resources.wfsahq.org/atotw/emergence-delirium-in-pediatric-patients/ WFSA: Emergence Delirium in Pediatric Patients]

[https://www.jopan.org/article/S1089-9472(04)00402-2/pdf Sevoflurane and emergence behavioral changes in pediatrics]

[https://www.bjaed.org/article/S2058-5349(17)30179-8/fulltext Emergence delirium after paediatric anaesthesia: new strategies in avoidance and treatment]

[https://pubmed.ncbi.nlm.nih.gov/29508484/ A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale]

[https://pubmed.ncbi.nlm.nih.gov/28203739/ Paediatric emergence delirium: a comprehensive review and interpretation of the literature]

[https://pubmed.ncbi.nlm.nih.gov/34309126/ Behavioral changes after hospital discharge in preschool children experiencing emergence delirium after general anesthesia: A prospective observational study.]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14297 Adult behavior toward the child before surgery and pediatric emergence delirium]

[https://pubmed.ncbi.nlm.nih.gov/34861083/ The effects of intraoperative magnesium sulfate administration on emergence agitation and delirium in pediatric patients: A systematic review and meta-analysis of randomized controlled trials]

[https://www.bjanaesthesia.org/article/S0007-0912(22)00013-7/fulltext Postoperative delirium and changes in the blood–brain barrier, neuroinflammation, and cerebrospinal fluid lactate: a prospective cohort study]

[https://pubmed.ncbi.nlm.nih.gov/35433300/ Pediatric Anesthesia Emergence Delirium Scale: A diagnostic meta-analysis]

[https://www.frontiersin.org/articles/10.3389/fsurg.2022.1031010/ Efficacy of propofol for the prevention of emergence agitation after sevoflurane anaesthesia in children: A meta-analysis]

[https://academic.oup.com/bja/article/118/3/335/2999642 Paediatric emergence delirium: a comprehensive review and interpretation of the literature]

[https://pubmed.ncbi.nlm.nih.gov/36557062/ Relationship between Fasting Times and Emergence Delirium in Children Undergoing Magnetic Resonance Imaging under Sedation]

[https://pubmed.ncbi.nlm.nih.gov/23763562/ Prevention of sevoflurane delirium and agitation with propofol]

[https://pubmed.ncbi.nlm.nih.gov/34918443/ Single bolus dexmedetomidine versus propofol for treatment of pediatric emergence delirium following general anesthesia]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14602 Comparison of intravenous and inhalation anesthesia on postoperative behavior changes in children undergoing ambulatory endoscopic procedures: A randomized clinical trial]

[https://www.podbean.com/ep/pb-pp6wg-13af1d5 Podcast]

[https://pubmed.ncbi.nlm.nih.gov/15752391/ Delayed emergence process does not result in a lower incidence of emergence agitation after sevoflurane anesthesia in children]

[https://pubmed.ncbi.nlm.nih.gov/37741935/ Risk Factors and Nomogram Model of Postoperative Delirium in Children with Congenital Heart Disease: A Single-Center Prospective Study]

[https://pubmed.ncbi.nlm.nih.gov/38093624/ Incidence of emergence agitation in children undergoing sevoflurane anesthesia compared to isoflurane anesthesia: An updated systematic review and meta-analysis]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000004929/139734/EEG-biomarkers-from-anesthesia-induction-to EEG biomarkers from anesthesia induction to identify vulnerable patients at risk for postoperative delirium]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000005077/141461/Effect-of-Remimazolam-on-Emergence-Delirium-in Effect of Remimazolam on Emergence Delirium in Children Undergoing Laparoscopic Surgery: A Double-Blinded Randomized Trial]

[https://journals.lww.com/anesthesiology/fulltext/9900/preoperative_electroencephalography_biomarkers_to.644.aspx Preoperative Electroencephalography Biomarkers to Identify Children at Risk for Emergence Delirium]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/05000/electroencephalographic_measures_of_delirium_in.24.aspx Electroencephalographic Measures of Delirium in the Perioperative Setting: A Systematic Review]

Volatile anesthesia

[https://pubmed.ncbi.nlm.nih.gov/17040302/ Emergence agitation in preschool children: double-blind, randomized, controlled trial comparing sevoflurane and isoflurane anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/17184433/ Isoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children--a randomized controlled study]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/quantitative_electroencephalogram_changes_before.19.aspx/ Quantitative Electroencephalogram Changes before and after Postoperative Delirium: A Prospective, Multicenter Cohort Study]

Non-pharmacological Interventions

[https://www.sciencedirect.com/science/article/abs/pii/S0952818025001114 The effect of repeated maternal voice orientation on postoperative emergence agitation in children following tonsillectomy and adenoidectomy: A randomized controlled trial]

[https://www.sciencedirect.com/science/article/pii/S0007091218302241 Mother's recorded voice on emergence can decrease postoperative emergence delirium from general anaesthesia in paediatric patients: a prospective randomised controlled trial]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16681 Dose-dependent relationship between intra-operative ketamine administration and postoperative delirium: a retrospective cohort study]

Emergence Delirium

2026-05-12T15:44:06Z

WikiSysop:

{{Stub Notice}}

Emergence Agitation/Delirium

[https://resources.wfsahq.org/atotw/emergence-delirium-in-pediatric-patients/ WFSA: Emergence Delirium in Pediatric Patients]

[https://www.jopan.org/article/S1089-9472(04)00402-2/pdf Sevoflurane and emergence behavioral changes in pediatrics]

[https://www.bjaed.org/article/S2058-5349(17)30179-8/fulltext Emergence delirium after paediatric anaesthesia: new strategies in avoidance and treatment]

[https://pubmed.ncbi.nlm.nih.gov/29508484/ A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale]

[https://pubmed.ncbi.nlm.nih.gov/28203739/ Paediatric emergence delirium: a comprehensive review and interpretation of the literature]

[https://pubmed.ncbi.nlm.nih.gov/34309126/ Behavioral changes after hospital discharge in preschool children experiencing emergence delirium after general anesthesia: A prospective observational study.]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14297 Adult behavior toward the child before surgery and pediatric emergence delirium]

[https://pubmed.ncbi.nlm.nih.gov/34861083/ The effects of intraoperative magnesium sulfate administration on emergence agitation and delirium in pediatric patients: A systematic review and meta-analysis of randomized controlled trials]

[https://www.bjanaesthesia.org/article/S0007-0912(22)00013-7/fulltext Postoperative delirium and changes in the blood–brain barrier, neuroinflammation, and cerebrospinal fluid lactate: a prospective cohort study]

[https://pubmed.ncbi.nlm.nih.gov/35433300/ Pediatric Anesthesia Emergence Delirium Scale: A diagnostic meta-analysis]

[https://www.frontiersin.org/articles/10.3389/fsurg.2022.1031010/ Efficacy of propofol for the prevention of emergence agitation after sevoflurane anaesthesia in children: A meta-analysis]

[https://academic.oup.com/bja/article/118/3/335/2999642 Paediatric emergence delirium: a comprehensive review and interpretation of the literature]

[https://pubmed.ncbi.nlm.nih.gov/36557062/ Relationship between Fasting Times and Emergence Delirium in Children Undergoing Magnetic Resonance Imaging under Sedation]

[https://pubmed.ncbi.nlm.nih.gov/23763562/ Prevention of sevoflurane delirium and agitation with propofol]

[https://pubmed.ncbi.nlm.nih.gov/34918443/ Single bolus dexmedetomidine versus propofol for treatment of pediatric emergence delirium following general anesthesia]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14602 Comparison of intravenous and inhalation anesthesia on postoperative behavior changes in children undergoing ambulatory endoscopic procedures: A randomized clinical trial]

[https://www.podbean.com/ep/pb-pp6wg-13af1d5 Podcast]

[https://pubmed.ncbi.nlm.nih.gov/15752391/ Delayed emergence process does not result in a lower incidence of emergence agitation after sevoflurane anesthesia in children]

[https://pubmed.ncbi.nlm.nih.gov/37741935/ Risk Factors and Nomogram Model of Postoperative Delirium in Children with Congenital Heart Disease: A Single-Center Prospective Study]

[https://pubmed.ncbi.nlm.nih.gov/38093624/ Incidence of emergence agitation in children undergoing sevoflurane anesthesia compared to isoflurane anesthesia: An updated systematic review and meta-analysis]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000004929/139734/EEG-biomarkers-from-anesthesia-induction-to EEG biomarkers from anesthesia induction to identify vulnerable patients at risk for postoperative delirium]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000005077/141461/Effect-of-Remimazolam-on-Emergence-Delirium-in Effect of Remimazolam on Emergence Delirium in Children Undergoing Laparoscopic Surgery: A Double-Blinded Randomized Trial]

[https://journals.lww.com/anesthesiology/fulltext/9900/preoperative_electroencephalography_biomarkers_to.644.aspx Preoperative Electroencephalography Biomarkers to Identify Children at Risk for Emergence Delirium]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/05000/electroencephalographic_measures_of_delirium_in.24.aspx Electroencephalographic Measures of Delirium in the Perioperative Setting: A Systematic Review]

Volatile anesthesia

[https://pubmed.ncbi.nlm.nih.gov/17040302/ Emergence agitation in preschool children: double-blind, randomized, controlled trial comparing sevoflurane and isoflurane anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/17184433/ Isoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children--a randomized controlled study]

Non-pharmacological Interventions

[https://www.sciencedirect.com/science/article/abs/pii/S0952818025001114 The effect of repeated maternal voice orientation on postoperative emergence agitation in children following tonsillectomy and adenoidectomy: A randomized controlled trial]

[https://www.sciencedirect.com/science/article/pii/S0007091218302241 Mother's recorded voice on emergence can decrease postoperative emergence delirium from general anaesthesia in paediatric patients: a prospective randomised controlled trial]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16681 Dose-dependent relationship between intra-operative ketamine administration and postoperative delirium: a retrospective cohort study]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/quantitative_electroencephalogram_changes_before.19.aspx/ Quantitative Electroencephalogram Changes before and after Postoperative Delirium: A Prospective, Multicenter Cohort Study]

Psychological Preparation of the Pediatric Patient & Family

2026-05-12T15:42:27Z

WikiSysop:

This is a Stub Notice. This page has not been completed. You can work on this page by signing in and going to the Edit tab. Thanks for helping to make PedsAnesthesia.Net Wiki useful.

Go to the [[Main Page]] to see the Topic Outline.

Go to the [[Generalized Suggested Outline]] for information on case-specific details for each page.

Go to the [[Test Page]] for examples on how to use references in the page.

[https://pubmed.ncbi.nlm.nih.gov/31869478/ Reducing preoperative anxiety with Child Life preparation prior to intravenous induction of anesthesia: A randomized controlled trial]

[https://pubmed.ncbi.nlm.nih.gov/26176357/ Video Distraction and Parental Presence for the Management of Preoperative Anxiety and Postoperative Behavioral Disturbance in Children: A Randomized Controlled Trial]

[https://pubmed.ncbi.nlm.nih.gov/26171895/ Non-pharmacological interventions for assisting the induction of anaesthesia in children]

[https://pubmed.ncbi.nlm.nih.gov/16199685/ Clown doctors as a treatment for preoperative anxiety in children: a randomized, prospective study]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000005105/141923/Identification-and-Treatment-of-Pediatric Identification and Treatment of Pediatric Perioperative Anxiety]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2024/12000/three_messages_to_enhance_human_connection_with.34.aspx Three Messages to Enhance Human Connection With Our Patients]

[https://www.nytimes.com/2025/02/17/opinion/theres-one-lie-i-will-never-tell-my-children.html There’s One Lie I will Never Tell My Children. New York Times 2025; CLXXIV: Opinion Guest essay]

[https://doi.org/10.1207/S15326888CHC2903_2 The Effects of Parental Reassurance Versus Distraction on Child Distress and Coping During Immunizations]

[https://onlinelibrary.wiley.com/doi/10.1002/ejp.1284 Communicating with children about ‘everyday’ pain and injury: A Delphi study]

[https://onlinelibrary.wiley.com/doi/10.1002/ejp.1284 Behavioral Approaches to Anxiety and Pain Management for Pediatric Venous Access]

[https://pubmed.ncbi.nlm.nih.gov/20042440/ Nocebo-Induced Hyperalgesia During Local Anesthetic Injection]

[https://pubmed.ncbi.nlm.nih.gov/16310653/ Preoperative psychological preparation of the child for surgery: an update]

[https://pubmed.ncbi.nlm.nih.gov/20199609/ Perioperative anxiety in children]

[https://pubmed.ncbi.nlm.nih.gov/16882820/ Preoperative anxiety, postoperative pain, and behavioral recovery in young children undergoing surgery]

[https://jamanetwork.com/journals/jama/fullarticle/2839303 How to Communicate Medical Numbers]

[https://www.chla.org/sites/default/files/atoms/files/CHLA-AAP-Responding-to-Childrens-Emotional-Needs_0.pdf Responding to Children's Emotional Needs During a Time of Crisis]

[https://www.sciencedirect.com/science/article/pii/S0104001425001356 Therapeutic misconceptions: the protective role of the perioperative team]

[https://journals.lww.com/anesthesiology/abstract/9900/perspectives_of_children,_parents_and_health_care.881.aspx Perspectives of children, parents and health care providers on outcomes following anesthesia for surgery:: An international mixed methods stakeholder engagement study from the Pediatric Perioperative Outcomes Group]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.70126 Research priorities for paediatric peri-operative medicine identified by Australian children and young people]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2026/04000/the_number_needed_to_treat_for_music_as_a_medicine.3.aspx The Number Needed to Treat for Music as a Medicine against Perioperative Anxiety: A Systematic Review and Meta-Analysis]
:[https://journals.lww.com/anesthesia-analgesia/fulltext/2026/04000/music_for_perioperative_anxiety__a_low_risk,.1.aspx EDITORIAL Music for Perioperative Anxiety: A Low-Risk, High-Value Intervention]

[https://pubmed.ncbi.nlm.nih.gov/40981164/ Lavender-Neroli Aromatherapy for Reducing Dental Anxiety and Pain in Children During Anesthesia: A Two-Arm Randomized Controlled Trial]

[https://pubmed.ncbi.nlm.nih.gov/32891272/ The effects of lavender aromatherapy on stress and pain perception in children during dental treatment: A randomized clinical trial]

Karaman T, Karaman S, Dogru S, Tapar H, Sahin A, Suren M, Arici S, Kaya Z. [https://pubmed.ncbi.nlm.nih.gov/27157961/ Evaluating the efficacy of lavender aromatherapy on peripheral venous cannulation pain and anxiety: A prospective, randomized study.] Complement Ther Clin Pract. 2016 May;23:64-8. doi: 10.1016/j.ctcp.2016.03.008. Epub 2016 Mar 25. PMID: 27157961.

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/development_and_validation_of_evanpedia_for_the.15.aspx/ Development and Validation of EVANpedia for the Assessment of Perioperative Experience in Pediatric Patients]

The family as patient.

Child Life Services.

Propofol

2026-05-12T15:36:40Z

WikiSysop:

{{Stub Notice}}

[https://www.bjanaesthesia.org/article/S0007-0912(25)00277-6/fulltext The amnesic effects of propofol on functional connectivity in the hippocampus determined by functional magnetic resonance imaging in volunteers]

[https://pubmed.ncbi.nlm.nih.gov/30378102/ Guidelines for the safe practice of total intravenous anaesthesia (TIVA): Joint Guidelines from the Association of Anaesthetists and the Society for Intravenous Anaesthesia]

[https://www.bjaed.org/article/S2058-5349(17)30022-7/fulltext Paediatric total intravenous anaesthesia]

[https://onlinelibrary.wiley.com/doi/abs/10.1111/pan.14021 An approach to using pharmacokinetics and electroencephalography for propofol anesthesia for surgery in infants]

[https://journals.lww.com/anesthesiology/fulltext/2025/08000/breath_analysis_of_propofol_and_associated.20.aspx Breath Analysis of Propofol and Associated Metabolic Signatures: A Pilot Study Using Secondary Electrospray Ionization–High-resolution Mass Spectrometry]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15561 Drug mixtures and infusion technology. MasterChef or Hell’s Kitchen?]

[https://pubmed.ncbi.nlm.nih.gov/10209973/ Propofol-infusion syndrome in children]

[https://pubmed.ncbi.nlm.nih.gov/36136079/ Age-Stratified Propofol Dosage for Pediatric Procedural Sedation and Analgesia]

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5155459/ Pain on propofol injection: Causes and remedies]

[https://pubmed.ncbi.nlm.nih.gov/23763562/ Prevention of sevoflurane delirium and agitation with propofol]

Willman EV, Andolfatto G (January 2007). "A prospective evaluation of "ketofol" (ketamine/propofol combination) for procedural sedation and analgesia in the emergency department". Annals of Emergency Medicine. 49 (1): 23–30. doi:10.1016/j.annemergmed.2006.08.002. PMID 17059854.

Jalili M, Bahreini M, Doosti-Irani A, Masoomi R, Arbab M, Mirfazaelian H (March 2016). "Ketamine-propofol combination (ketofol) vs propofol for procedural sedation and analgesia: systematic review and meta-analysis". The American Journal of Emergency Medicine. 34 (3): 558–69. doi:10.1016/j.ajem.2015.12.074. PMID 26809929.

[https://www.bjanaesthesia.org/article/S0007-0912(23)00254-4/fulltext Volatile versus intravenous anaesthesia and perioperative neurocognitive disorders: anything to see here?]

[https://www.bjanaesthesia.org/article/S0007-0912(17)48037-8/fulltext PHARMACOKINETIC MODEL DRIVEN INFUSION OF PROPOFOL IN CHILDREN]

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5155459/ Pain on propofol injection: Causes and remedies]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00063-1/fulltext Remimazolam versus propofol for sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis]

[https://link.springer.com/article/10.1007/s10916-024-02108-5 The Potential for a Propofol Volume and Dosing Decision Support Tool in an Electronic Health Record System to Provide Anticipated Propofol Volumes and Reduce Waste]

[https://simtiva.app/ SimTIVA app]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00153-3/fulltext Comparison of postoperative pain in children after maintenance anaesthesia with propofol or sevoflurane: a systematic review and meta-analysis]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00314-3/abstract Propofol infusion syndrome (PRIS) incidence and related symptoms in children: a retrospective analysis of a nationwide hospital-based database in Japan]

[https://resources.wfsahq.org/atotw/adjuvant-medications-for-use-with-propofol-based-total-intravenous-anaesthesia/ Adjuvant Medications for Use With Propofol-Based Total Intravenous Anaesthesia]

Wu Y, Chen Z, Yao C, et al. Effect of systemic lidocaine on postoperative quality of recovery, the gastrointestinal function, inflammatory cytokines of lumbar spinal stenosis surgery: a randomized trial. Sci Rep. 2023 Oct; 13(1): 17661. PMID: 37848527

Hall EA, Sauer HE, Davis MS, Anghelescu DL. Lidocaine infusions for pain management in pediatrics. Paediatr Drugs. 2021 Jul; 23(4): 349-359. PMID: 34036532

Mooney JJ, Pagel PS, Kundu A. Safety, tolerability, and short-term efficacy of intravenous lidocaine infusions for the treatment of chronic pain in adolescents and young adults: a preliminary report. Pain Med. 2014 May; 15(5): 820-825. PMID: 24423053

[https://pubmed.ncbi.nlm.nih.gov/38381704/ Effect of Propofol Infusion on Need for Rescue Antiemetics in Postanesthesia Care Unit After Volatile Anesthesia: A Retrospective Cohort Study]

[https://pubmed.ncbi.nlm.nih.gov/25312700/ Total intravenous anesthesia will supercede inhalational anesthesia in pediatric anesthetic practice]

[https://www.bjanaesthesia.org/article/S0007-0912(25)00350-2/fulltext Impact of genetic variations on the pharmacokinetics, dose requirements, and clinical effects of propofol: a systematic review]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/12000/single_syringe_total_intravenous_anesthesia_with.8.aspx Single-Syringe Total Intravenous Anesthesia With Propofol and Remifentanil: A Prospective Cohort Study] Comment: [https://journals.lww.com/anesthesia-analgesia/fulltext/2025/12000/cutting_corners__is_mixing_remifentanil_and.7.aspx Cutting Corners: Is Mixing Remifentanil and Propofol a Bad Idea?]

[https://pubmed.ncbi.nlm.nih.gov/34039280/ Correlation of exhaled propofol with Narcotrend index and calculated propofol plasma levels in children undergoing surgery under total intravenous anesthesia - an observational study]

[https://pubmed.ncbi.nlm.nih.gov/39759290/ Online monitoring of propofol concentrations in exhaled breath]

[https://pubmed.ncbi.nlm.nih.gov/17413902/ On-line monitoring of end-tidal propofol concentration in anesthetized patients]

[https://pubmed.ncbi.nlm.nih.gov/17413903/ Real-time monitoring of propofol in expired air in humans undergoing total intravenous anesthesia]

[https://journals.lww.com/anesthesiology/fulltext/2025/12000/effect_of_intravenous,_inhalational,_or_combined.13.aspx Effect of Intravenous, Inhalational, or Combined Anesthesia Maintenance on Postoperative Respiratory Adverse Events in Children Undergoing Adenotonsillectomy (AmPRAEC): A Multicenter Randomized Clinical Trial]
:[https://journals.lww.com/anesthesiology/fulltext/2025/12000/choice_of_anesthetic_maintenance_is_not_merely_a.8.aspx Editorial: Choice of Anesthetic Maintenance Is Not Merely a Matter of Preference, but One of Safety: Insights from the AmPRAEC Study]

[https://www.bjanaesthesia.org/article/S0007-0912(25)00670-1/abstract Integrated 3D human cerebral organoids and paediatric patient serum analysis reveals mechanisms and biomarkers of anaesthetic-induced neurotoxicity]

[https://journals.lww.com/co-anesthesiology/abstract/9900/update_on_total_intravenous_anesthesia_in_children.404.aspx Update on total intravenous anesthesia in children]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/optimal_fresh_gas_flow_when_employing_total.14.aspx/ Optimal Fresh Gas Flow when Employing Total Intravenous Anesthesia]

Point of Care Ultrasound - POCUS

2026-05-12T15:05:48Z

WikiSysop:

{{Stub Notice}}

[https://www.bjaed.org/article/S2058-5349(25)00075-7/abstract Point-of-care ultrasonography in paediatric anaesthesia]

[https://resources.wfsahq.org/atotw/pocus-paediatric-anaesthesia/ WFSA: Point of Care Ultrasound: Applications in Paediatric Anaesthesia]

[https://rapm.bmj.com/content/early/2025/07/15/rapm-2025-106926 ASRA pain medicine narrative review and expert practice recommendations for gastric point-of-care ultrasound to assess aspiration risk in medically complex patients undergoing regional anesthesia and pain procedures: infographic]

[https://pubmed.ncbi.nlm.nih.gov/37260313/ Pediatric Research Collaborative on Critical Ultrasound (PeRCCUS), a subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. A Program of Assessment Model for Point-of-Care Ultrasound Training for Pediatric Critical Care Providers: A Comprehensive Approach to Enhance Competency-Based Point-of-Care Ultrasound Training]

Singh Y, Tissot C, Fraga MV, Yousef N, Cortes RG, Lopez J, Sanchez-de-Toledo J, Brierley J, Colunga JM, Raffaj D, Da Cruz E, Durand P, Kenderessy P, Lang HJ, Nishisaki A, Kneyber MC, Tissieres P, Conlon TW, De Luca D: International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Crit Care 2020; 24: 65

Marin JR, Lewiss RE: Point-of-care ultrasonography by pediatric emergency medicine physicians. Pediatrics 2015; 135: e1113-22

Ryan MS, Holmboe ES, Chandra S: Competency-Based Medical Education: Considering Its Past, Present, and a Post-COVID-19 Era. Acad Med 2022; 97: S90-s97

[https://pubmed.ncbi.nlm.nih.gov/38358309/ The state of point-of-care ultrasound training in pediatric anesthesia fellowship programs in the United States: A survey assessment]

[https://journals.lww.com/aacr/fulltext/2023/08000/ultrasound_rounds__anesthesiologist_performed.1.aspx Ultrasound Rounds: Anesthesiologist-Performed Intraoperative Point-of-Care Focused Assessment With Sonography in Trauma Examination Changes Surgical Management]

[https://link.springer.com/article/10.1007/s12630-024-02746-w Competencies for proficiency in basic point-of-care ultrasound in anesthesiology: national expert recommendations using Delphi methodology]

[https://beta.openanesthesia.org/vodcasts/ OpenAnesthesia Vodcasts]

[http://pie.med.utoronto.ca/tte/ Virtual Transthoracic Echocardiography]

[https://www.asra.com/news-publications/asra-newsletter/newsletter-item/asra-news/2025/02/05/pocus-for-the-pediatric-anesthesiologist POCUS for the Pediatric Anesthesiologist]

[https://opencriticalcare.org/wp-content/uploads/2022/04/POCUS_030422.4.20-o1nd2u.pdf POCUS reference card]

[https://www.cdc.gov/healthcare-associated-infections/bulletins/outbreak-ultrasound-gel.html CDC Alert: Use Only Sterile Ultrasound Gel for Percutaneous Procedures]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/assessment_of_gastric_content_using_gastric.1493.aspx Assessment of Gastric Content Using Gastric Ultrasound in Patients on Glucagon-Like Peptide-1 Receptor Agonists Before Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/25495405/ Ultrasound assessment of gastric volume in the fasted pediatric patient undergoing upper gastrointestinal endoscopy: development of a predictive model using endoscopically suctioned volumes]

https://journals.lww.com/anesthesiology/fulltext/2026/06000/multiplanar_ultrasonographic_assessment_of_gastric.13.aspx/

https://pubmed.ncbi.nlm.nih.gov/?term=Pediatric+anesthesia+pocus

The Former Premature Patient

2026-05-12T15:02:23Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/8295802/ Anesthesia and apnea. Perioperative considerations in the former preterm infant]

[https://pubmed.ncbi.nlm.nih.gov/2382858/ Life-threatening apnea following spinal anesthesia in former premature infants]

[https://pubmed.ncbi.nlm.nih.gov/14766693/ The distance from the skin to the subarachnoid space can be predicted in premature and former-premature infants]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/postanesthesia_apnea_in_former_preterm_and_term.27.aspx Postanesthesia Apnea in Former Preterm and Term Infants: A Qualitative Systematic Review and Meta-analysis]

Post Operative Apnea

2026-05-12T15:01:43Z

WikiSysop:

{{Stub Notice}}

Davidson AJ, Morton NS, Arnup SJ, et al. Apnea after awake regional and general anesthesia in infants: the general anesthesia compared to spinal anesthesia study--comparing apnea and neurodevelopmental outcomes, a randomized controlled trial. Anesthesiology. 2015 Jul; 123(1): 38-54. PMID: 26001033

Ozdemir T, Arikan A. Postoperative apnea after inguinal hernia repair in formerly premature infants: impacts of gestational age, postconceptual age and comorbidities. Pediatr Surg Int. 2013 Aug; 29(8): 801-804. PMID: 23780479

[https://www.apsf.org/article/postoperative-apnea-and-former-preterm-infant-evolving-evidence-for-management/ APSF Newsletter: Postoperative Apnea and Former Preterm Infant: Evolving Evidence for Management]

Lu-Boettcher YE, Koka R, Dalal PG, Coté CJ: Postoperative Apnea and Former Preterm Infant: Evolving Evidence for Management, Anesthesia Patient Safety Foundation, 2025

Cote CJ, Zaslavsky A, Downes JJ, Kurth CD, Welborn LG, Warner LO, Malviya SV: Postoperative apnea in former preterm infants after inguinal herniorrhaphy. A combined analysis [see comments]. Anesthesiology 1995; 82: 809–822

Kurth CD, Spitzer AR, Broennle AM, Downes JJ: Postoperative apnea in preterm infants. Anesthesiology 1987; 66: 483–488

Zhao J, Gonzalez F, Mu D: Apnea of prematurity: from cause to treatment. Eur J Pediatr 2011; 170: 1097–105

Engle WA: Age terminology during the perinatal period. Pediatrics 2004; 114: 1362–4

Eichenwald EC: Apnea of Prematurity. Pediatrics 2016; 137

Erickson G, Dobson NR, Hunt CE: Immature control of breathing and apnea of prematurity: the known and unknown. J Perinatol 2021; 41: 2111–2123

Abajian JC, Mellish RW, Browne AF, Perkins FM, Lambert DH, Mazuzan JE, Jr.: Spinal anesthesia for surgery in the high-risk infant. Anesth.Analg. 1984; 63: 359–362

Davidson AJ, Morton NS, Arnup SJ, de Graaff JC, Disma N, Withington DE, Frawley G, Hunt RW, Hardy P, Khotcholava M, von Ungern Sternberg BS, Wilton N, Tuo P, Salvo I, Ormond G, Stargatt R, Locatelli BG, McCann ME: Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial. Anesthesiology 2015; 123: 38–54

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/postanesthesia_apnea_in_former_preterm_and_term.27.aspx Postanesthesia Apnea in Former Preterm and Term Infants: A Qualitative Systematic Review and Meta-analysis]

Mitochondrial Disease

2026-05-12T14:59:52Z

WikiSysop:

{{Stub Notice}}

See also: [[Leigh’s Syndrome]]

[https://pubmed.ncbi.nlm.nih.gov/27885500/ A review of anaesthetic outcomes in patients with genetically confirmed mitochondrial disorders]

[https://med.stanford.edu/content/dam/sm/pedsanesthesia/documents/mitochondrial-disease.pdf Mitochondrial Disease and Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/33591116/ Anesthetic Hypersensitivity in a Case-Controlled Series of Patients With Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/25503498/ Diagnosis and management of mitochondrial disease: a consensus statement from the Mitochondrial Medicine Society]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.12158 Anesthetic considerations in patients with mitochondrial defects]

[https://pubmed.ncbi.nlm.nih.gov/33752971/ Hypoxia ameliorates brain hyperoxia and NAD(+) deficiency in a murine model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/26917594/ Hypoxia as a therapy for mitochondrial disease]

[https://www.openanesthesia.org/vodcasts/anesthetic-considerations-in-patients-with-mitochondrial-disease/ Open Anesthesia: Anesthetic Considerations in Patients with Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/23923677/ Mitochondrial diseases and anesthesia: a literature review of current opinions]

[https://pubmed.ncbi.nlm.nih.gov/23007905/ Anesthesia for children with mitochondrial disorders: a national survey and review]

[https://pubmed.ncbi.nlm.nih.gov/32574972/ Sevoflurane as opposed to propofol anesthesia preserves mitochondrial function and alleviates myocardial ischemia/reperfusion injury]

Perioperative management of a child with short-chain acyl CoA dehydrogenase deficiency.
Pediatr Anesth 2005; 15: 771-7.

Hsieh VC, Krane EJ, Morgan PG. Mitochondrial disease and anesthesia. JIEMS. 2017;5:1–5

Kishikawa J-I, Inoue Y, Fujikawa M, Nishimura K, Nakanishi A, Tanabe T, et al. General anesthetics cause mitochondrial dysfunction and reduction of intracellular ATP levels. PLoS ONE. 2018;13:e0190213. doi: 10.1371/journal.pone.0190213

[https://pmc.ncbi.nlm.nih.gov/articles/PMC5278534 Anesthetic Management of a Child With Unspecified Mitochondrial Disease in an Outpatient Dental Setting]

[https://journals.lww.com/anesthesiology/abstract/2026/04000/effects_of_isoflurane_inhibition_of_mitochondrial.23.aspx Effects of Isoflurane Inhibition of Mitochondrial Complex I on Calcium Removal in Mouse Neuronal Cultures]

MT-ND4

[https://www.asahq.org/advocating-for-you/genetic-anesthesia-neurologic-mortality-risks ASA Information Page]

[https://journals.lww.com/anesthesiology/fulltext/9900/potential_mitochondrial_pharmacogenetic.904.aspx Potential Mitochondrial Pharmacogenetic Susceptibility to Severe Neurologic Events after General Anesthesia: Report from the Chilean Ministry of Health]
:[https://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=9900&issue=00000&article=00979&type=Fulltext Editorial: Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

[https://medlineplus.gov/genetics/gene/mt-nd4/ MT-ND4 gene: mitochondrially encoded NADH dehydrogenase 4]

[https://pedsanesthesia.net/forum/viewtopic.php?t=1352 Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children(Forum thread)]

[https://www.clinsurgeryjournal.com/index.php/ascr/article/view/ascr-aid1091/pdf Short Communication:Mitochondrial Genetic Susceptibility to Anesthetic Neurotoxicity in Venezuelan Pediatric Patients: A Call for Vigilance and Further Research]

[https://pedsanesthesia.org/joint-communication-from-the-society-for-pediatric-anesthesia-and-american-society-of-anesthesiologists-regarding-severe-neurological-complications-and-death-after-general-anesthesia-in-venezuelan-chi/ Joint Communication from the Society for Pediatric Anesthesia and American Society of Anesthesiologists Regarding Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children]

[https://youtu.be/cKuFfUwxSx4?si=v-WqKAO5gQerTKwu Part of the webinar series Hot Topics in Pediatric Anesthesia, presented by the Pediatric Anesthesia Committee of the Florida Society of Anesthesiologists, Rosalie Tassone, MD, Chair. "Bad Outcomes in Strange Times - Update on the ASA/SPA Communications Regarding Pediatric Patients of Venezuelan Families" presented by Luis Rodriguez, MD (originally presented on November 12, 2025)]

[https://www.asahq.org/advocating-for-you/guidance/asa-spa-neurological Update regarding severe neurological complications and death after general anesthesia in adult and pediatric patients of Venezuelan ancestry (January 27, 2026)]

[https://www.pnas.org/doi/10.1073/pnas.1621511114 Hypoxia treatment reverses neurodegenerative disease in a mouse model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/37770252/ Volatile anaesthetic toxicity in the genetic mitochondrial disease Leigh syndrome]

[https://journals.lww.com/anesthesiology/abstract/9900/effects_of_a_mitochondrial_genetic_variant_on.912.aspx Effects of a mitochondrial genetic variant on sevoflurane hypersensitivity]

[https://esaic.org/joint-statement-on-anaesthesia-related-mitochondrial-pharmacogenetic-risk-in-individuals-with-venezuelan-maternal-ancestry/ ESAIC News: Joint Statement on Anaesthesia-Related Mitochondrial Pharmacogenetic Risk in Individuals with Venezuelan Maternal Ancestry]

[https://kevinmd.com/2026/04/how-a-hidden-genetic-mutation-creates-a-severe-pediatric-anesthesia-risk.html KevinMD: How a hidden genetic mutation creates a severe pediatric anesthesia risk]

[https://revistachilenadeanestesia.cl/revchilanestv55n2-18/ Recomendaciones anestésicas frente a una variante genética infrecuente en población con ascendencia venezolana, con posible asociación a complicaciones neurológicas severas tras anestesia general (Anesthetic recommendations regarding a rare genetic variant in a population with Venezuelan ancestry, with a possible association with severe neurological complications following general anesthesia]

[https://www.sciencedirect.com/science/article/abs/pii/S0034935626000708 Encefalopatía aguda asociada a anestesia general en un paciente adulto portador de la variante m.11232T>C en el gen MT-ND4 (An adult case of acute encephalopathy associated with general anesthesia and the m.11232T>C MT-ND4 variant)]

[https://tools.sodapdf.com/document/6287485d-7db3-42e5-90c2-8f668e846b4a Emerging Reports of Severe Neurological Complications Following General Anesthesia in Patients with Maternal Venezuelan Ancestry]

[https://player.vimeo.com/video/1179934920 Video for Parents (English)]

[https://player.vimeo.com/video/1179935060 Video for Parents (Español)]

[https://www.medscape.com/viewarticle/anesthetic-risk-linked-venezuelan-maternal-lineage-2026a10009ni?ecd=a2a&form=fpf Anesthetic Risk Linked to Venezuelan Maternal Lineage]

[https://journals.lww.com/monitor/fulltext/2026/03000/airs_case_2026_03__this_is_why_we_have_airs.10.aspx AIRS Case 2026-03: This Is Why We Have AIRS]

[https://www.apsf.org/article/perioperative-practices-for-patients-of-venezuelan-ancestry/ Perioperative Practices for Patients of Venezuelan Ancestry]

[https://sphere.nyssa-pga.org/2026/mitochondrial-genetic-susceptibility-to-anesthetics-in-patients-with-venezuelan-heritage/ Mitochondrial Genetic Susceptibility to Anesthetics in Patients with Venezuelan Heritage]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/hidden_in_the_haplotype__how_sevoflurane_may.5.aspx Hidden in the Haplotype: How Sevoflurane May Trigger Neurologic Injury in Adults and Children]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/ancient_mitochondrial_genetic_variant,_modern_day.7.aspx/ EDITORIAL: Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

Dehydrogenase Deficiency

[https://pubmed.ncbi.nlm.nih.gov/25069536/ Anesthetic agents in patients with very long-chain acyl-coenzyme A dehydrogenase deficiency: a literature review]

[https://pubmed.ncbi.nlm.nih.gov/27896927/ A retrospective review of anesthesia and perioperative care in children with medium-chain acyl-CoA dehydrogenase deficiency]

[https://pubmed.ncbi.nlm.nih.gov/22608595/ Perioperative management of a pediatric patient with short-chain acyl-CoA dehydrogenase deficiency]

Mitochondrial Disease

2026-05-12T14:59:03Z

WikiSysop:

{{Stub Notice}}

See also: [[Leigh’s Syndrome]]

[https://pubmed.ncbi.nlm.nih.gov/27885500/ A review of anaesthetic outcomes in patients with genetically confirmed mitochondrial disorders]

[https://med.stanford.edu/content/dam/sm/pedsanesthesia/documents/mitochondrial-disease.pdf Mitochondrial Disease and Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/33591116/ Anesthetic Hypersensitivity in a Case-Controlled Series of Patients With Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/25503498/ Diagnosis and management of mitochondrial disease: a consensus statement from the Mitochondrial Medicine Society]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.12158 Anesthetic considerations in patients with mitochondrial defects]

[https://pubmed.ncbi.nlm.nih.gov/33752971/ Hypoxia ameliorates brain hyperoxia and NAD(+) deficiency in a murine model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/26917594/ Hypoxia as a therapy for mitochondrial disease]

[https://www.openanesthesia.org/vodcasts/anesthetic-considerations-in-patients-with-mitochondrial-disease/ Open Anesthesia: Anesthetic Considerations in Patients with Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/23923677/ Mitochondrial diseases and anesthesia: a literature review of current opinions]

[https://pubmed.ncbi.nlm.nih.gov/23007905/ Anesthesia for children with mitochondrial disorders: a national survey and review]

[https://pubmed.ncbi.nlm.nih.gov/32574972/ Sevoflurane as opposed to propofol anesthesia preserves mitochondrial function and alleviates myocardial ischemia/reperfusion injury]

Perioperative management of a child with short-chain acyl CoA dehydrogenase deficiency.
Pediatr Anesth 2005; 15: 771-7.

Hsieh VC, Krane EJ, Morgan PG. Mitochondrial disease and anesthesia. JIEMS. 2017;5:1–5

Kishikawa J-I, Inoue Y, Fujikawa M, Nishimura K, Nakanishi A, Tanabe T, et al. General anesthetics cause mitochondrial dysfunction and reduction of intracellular ATP levels. PLoS ONE. 2018;13:e0190213. doi: 10.1371/journal.pone.0190213

[https://pmc.ncbi.nlm.nih.gov/articles/PMC5278534 Anesthetic Management of a Child With Unspecified Mitochondrial Disease in an Outpatient Dental Setting]

[https://journals.lww.com/anesthesiology/abstract/2026/04000/effects_of_isoflurane_inhibition_of_mitochondrial.23.aspx Effects of Isoflurane Inhibition of Mitochondrial Complex I on Calcium Removal in Mouse Neuronal Cultures]

MT-ND4

[https://www.asahq.org/advocating-for-you/genetic-anesthesia-neurologic-mortality-risks ASA Information Page]

[https://journals.lww.com/anesthesiology/fulltext/9900/potential_mitochondrial_pharmacogenetic.904.aspx Potential Mitochondrial Pharmacogenetic Susceptibility to Severe Neurologic Events after General Anesthesia: Report from the Chilean Ministry of Health]
:[https://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=9900&issue=00000&article=00979&type=Fulltext Editorial: Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

[https://medlineplus.gov/genetics/gene/mt-nd4/ MT-ND4 gene: mitochondrially encoded NADH dehydrogenase 4]

[https://pedsanesthesia.net/forum/viewtopic.php?t=1352 Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children(Forum thread)]

[https://www.clinsurgeryjournal.com/index.php/ascr/article/view/ascr-aid1091/pdf Short Communication:Mitochondrial Genetic Susceptibility to Anesthetic Neurotoxicity in Venezuelan Pediatric Patients: A Call for Vigilance and Further Research]

[https://pedsanesthesia.org/joint-communication-from-the-society-for-pediatric-anesthesia-and-american-society-of-anesthesiologists-regarding-severe-neurological-complications-and-death-after-general-anesthesia-in-venezuelan-chi/ Joint Communication from the Society for Pediatric Anesthesia and American Society of Anesthesiologists Regarding Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children]

[https://youtu.be/cKuFfUwxSx4?si=v-WqKAO5gQerTKwu Part of the webinar series Hot Topics in Pediatric Anesthesia, presented by the Pediatric Anesthesia Committee of the Florida Society of Anesthesiologists, Rosalie Tassone, MD, Chair. "Bad Outcomes in Strange Times - Update on the ASA/SPA Communications Regarding Pediatric Patients of Venezuelan Families" presented by Luis Rodriguez, MD (originally presented on November 12, 2025)]

[https://www.asahq.org/advocating-for-you/guidance/asa-spa-neurological Update regarding severe neurological complications and death after general anesthesia in adult and pediatric patients of Venezuelan ancestry (January 27, 2026)]

[https://www.pnas.org/doi/10.1073/pnas.1621511114 Hypoxia treatment reverses neurodegenerative disease in a mouse model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/37770252/ Volatile anaesthetic toxicity in the genetic mitochondrial disease Leigh syndrome]

[https://journals.lww.com/anesthesiology/abstract/9900/effects_of_a_mitochondrial_genetic_variant_on.912.aspx Effects of a mitochondrial genetic variant on sevoflurane hypersensitivity]

[https://esaic.org/joint-statement-on-anaesthesia-related-mitochondrial-pharmacogenetic-risk-in-individuals-with-venezuelan-maternal-ancestry/ ESAIC News: Joint Statement on Anaesthesia-Related Mitochondrial Pharmacogenetic Risk in Individuals with Venezuelan Maternal Ancestry]

[https://kevinmd.com/2026/04/how-a-hidden-genetic-mutation-creates-a-severe-pediatric-anesthesia-risk.html KevinMD: How a hidden genetic mutation creates a severe pediatric anesthesia risk]

[https://revistachilenadeanestesia.cl/revchilanestv55n2-18/ Recomendaciones anestésicas frente a una variante genética infrecuente en población con ascendencia venezolana, con posible asociación a complicaciones neurológicas severas tras anestesia general (Anesthetic recommendations regarding a rare genetic variant in a population with Venezuelan ancestry, with a possible association with severe neurological complications following general anesthesia]

[https://www.sciencedirect.com/science/article/abs/pii/S0034935626000708 Encefalopatía aguda asociada a anestesia general en un paciente adulto portador de la variante m.11232T>C en el gen MT-ND4 (An adult case of acute encephalopathy associated with general anesthesia and the m.11232T>C MT-ND4 variant)]

[https://tools.sodapdf.com/document/6287485d-7db3-42e5-90c2-8f668e846b4a Emerging Reports of Severe Neurological Complications Following General Anesthesia in Patients with Maternal Venezuelan Ancestry]

[https://player.vimeo.com/video/1179934920 Video for Parents (English)]

[https://player.vimeo.com/video/1179935060 Video for Parents (Español)]

[https://www.medscape.com/viewarticle/anesthetic-risk-linked-venezuelan-maternal-lineage-2026a10009ni?ecd=a2a&form=fpf Anesthetic Risk Linked to Venezuelan Maternal Lineage]

[https://journals.lww.com/monitor/fulltext/2026/03000/airs_case_2026_03__this_is_why_we_have_airs.10.aspx AIRS Case 2026-03: This Is Why We Have AIRS]

[https://www.apsf.org/article/perioperative-practices-for-patients-of-venezuelan-ancestry/ Perioperative Practices for Patients of Venezuelan Ancestry]

[https://sphere.nyssa-pga.org/2026/mitochondrial-genetic-susceptibility-to-anesthetics-in-patients-with-venezuelan-heritage/ Mitochondrial Genetic Susceptibility to Anesthetics in Patients with Venezuelan Heritage]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/hidden_in_the_haplotype__how_sevoflurane_may.5.aspx Hidden in the Haplotype: How Sevoflurane May Trigger Neurologic Injury in Adults and Children]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/ancient_mitochondrial_genetic_variant,_modern_day.7.aspx/ EDITORIAL: Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

Sanz-Pons J, Aladrén-Herrer C, Ortigoza-Escobar JD: Effects of a mitochondrial genetic variant on sevoflurane hypersensitivity. Anesthesiology 2026; 144:1286–98

Dehydrogenase Deficiency

[https://pubmed.ncbi.nlm.nih.gov/25069536/ Anesthetic agents in patients with very long-chain acyl-coenzyme A dehydrogenase deficiency: a literature review]

[https://pubmed.ncbi.nlm.nih.gov/27896927/ A retrospective review of anesthesia and perioperative care in children with medium-chain acyl-CoA dehydrogenase deficiency]

[https://pubmed.ncbi.nlm.nih.gov/22608595/ Perioperative management of a pediatric patient with short-chain acyl-CoA dehydrogenase deficiency]

Mitochondrial Disease

2026-05-12T14:57:49Z

WikiSysop:

{{Stub Notice}}

See also: [[Leigh’s Syndrome]]

[https://pubmed.ncbi.nlm.nih.gov/27885500/ A review of anaesthetic outcomes in patients with genetically confirmed mitochondrial disorders]

[https://med.stanford.edu/content/dam/sm/pedsanesthesia/documents/mitochondrial-disease.pdf Mitochondrial Disease and Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/33591116/ Anesthetic Hypersensitivity in a Case-Controlled Series of Patients With Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/25503498/ Diagnosis and management of mitochondrial disease: a consensus statement from the Mitochondrial Medicine Society]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.12158 Anesthetic considerations in patients with mitochondrial defects]

[https://pubmed.ncbi.nlm.nih.gov/33752971/ Hypoxia ameliorates brain hyperoxia and NAD(+) deficiency in a murine model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/26917594/ Hypoxia as a therapy for mitochondrial disease]

[https://www.openanesthesia.org/vodcasts/anesthetic-considerations-in-patients-with-mitochondrial-disease/ Open Anesthesia: Anesthetic Considerations in Patients with Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/23923677/ Mitochondrial diseases and anesthesia: a literature review of current opinions]

[https://pubmed.ncbi.nlm.nih.gov/23007905/ Anesthesia for children with mitochondrial disorders: a national survey and review]

[https://pubmed.ncbi.nlm.nih.gov/32574972/ Sevoflurane as opposed to propofol anesthesia preserves mitochondrial function and alleviates myocardial ischemia/reperfusion injury]

Perioperative management of a child with short-chain acyl CoA dehydrogenase deficiency.
Pediatr Anesth 2005; 15: 771-7.

Hsieh VC, Krane EJ, Morgan PG. Mitochondrial disease and anesthesia. JIEMS. 2017;5:1–5

Kishikawa J-I, Inoue Y, Fujikawa M, Nishimura K, Nakanishi A, Tanabe T, et al. General anesthetics cause mitochondrial dysfunction and reduction of intracellular ATP levels. PLoS ONE. 2018;13:e0190213. doi: 10.1371/journal.pone.0190213

[https://pmc.ncbi.nlm.nih.gov/articles/PMC5278534 Anesthetic Management of a Child With Unspecified Mitochondrial Disease in an Outpatient Dental Setting]

[https://journals.lww.com/anesthesiology/abstract/2026/04000/effects_of_isoflurane_inhibition_of_mitochondrial.23.aspx Effects of Isoflurane Inhibition of Mitochondrial Complex I on Calcium Removal in Mouse Neuronal Cultures]

MT-ND4

[https://www.asahq.org/advocating-for-you/genetic-anesthesia-neurologic-mortality-risks ASA Information Page]

[https://journals.lww.com/anesthesiology/fulltext/9900/potential_mitochondrial_pharmacogenetic.904.aspx Potential Mitochondrial Pharmacogenetic Susceptibility to Severe Neurologic Events after General Anesthesia: Report from the Chilean Ministry of Health]
:[https://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=9900&issue=00000&article=00979&type=Fulltext Editorial: Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

[https://medlineplus.gov/genetics/gene/mt-nd4/ MT-ND4 gene: mitochondrially encoded NADH dehydrogenase 4]

[https://pedsanesthesia.net/forum/viewtopic.php?t=1352 Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children(Forum thread)]

[https://www.clinsurgeryjournal.com/index.php/ascr/article/view/ascr-aid1091/pdf Short Communication:Mitochondrial Genetic Susceptibility to Anesthetic Neurotoxicity in Venezuelan Pediatric Patients: A Call for Vigilance and Further Research]

[https://pedsanesthesia.org/joint-communication-from-the-society-for-pediatric-anesthesia-and-american-society-of-anesthesiologists-regarding-severe-neurological-complications-and-death-after-general-anesthesia-in-venezuelan-chi/ Joint Communication from the Society for Pediatric Anesthesia and American Society of Anesthesiologists Regarding Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children]

[https://youtu.be/cKuFfUwxSx4?si=v-WqKAO5gQerTKwu Part of the webinar series Hot Topics in Pediatric Anesthesia, presented by the Pediatric Anesthesia Committee of the Florida Society of Anesthesiologists, Rosalie Tassone, MD, Chair. "Bad Outcomes in Strange Times - Update on the ASA/SPA Communications Regarding Pediatric Patients of Venezuelan Families" presented by Luis Rodriguez, MD (originally presented on November 12, 2025)]

[https://www.asahq.org/advocating-for-you/guidance/asa-spa-neurological Update regarding severe neurological complications and death after general anesthesia in adult and pediatric patients of Venezuelan ancestry (January 27, 2026)]

[https://www.pnas.org/doi/10.1073/pnas.1621511114 Hypoxia treatment reverses neurodegenerative disease in a mouse model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/37770252/ Volatile anaesthetic toxicity in the genetic mitochondrial disease Leigh syndrome]

[https://journals.lww.com/anesthesiology/abstract/9900/effects_of_a_mitochondrial_genetic_variant_on.912.aspx Effects of a mitochondrial genetic variant on sevoflurane hypersensitivity]

[https://esaic.org/joint-statement-on-anaesthesia-related-mitochondrial-pharmacogenetic-risk-in-individuals-with-venezuelan-maternal-ancestry/ ESAIC News: Joint Statement on Anaesthesia-Related Mitochondrial Pharmacogenetic Risk in Individuals with Venezuelan Maternal Ancestry]

[https://kevinmd.com/2026/04/how-a-hidden-genetic-mutation-creates-a-severe-pediatric-anesthesia-risk.html KevinMD: How a hidden genetic mutation creates a severe pediatric anesthesia risk]

[https://revistachilenadeanestesia.cl/revchilanestv55n2-18/ Recomendaciones anestésicas frente a una variante genética infrecuente en población con ascendencia venezolana, con posible asociación a complicaciones neurológicas severas tras anestesia general (Anesthetic recommendations regarding a rare genetic variant in a population with Venezuelan ancestry, with a possible association with severe neurological complications following general anesthesia]

[https://www.sciencedirect.com/science/article/abs/pii/S0034935626000708 Encefalopatía aguda asociada a anestesia general en un paciente adulto portador de la variante m.11232T>C en el gen MT-ND4 (An adult case of acute encephalopathy associated with general anesthesia and the m.11232T>C MT-ND4 variant)]

[https://tools.sodapdf.com/document/6287485d-7db3-42e5-90c2-8f668e846b4a Emerging Reports of Severe Neurological Complications Following General Anesthesia in Patients with Maternal Venezuelan Ancestry]

[https://player.vimeo.com/video/1179934920 Video for Parents (English)]

[https://player.vimeo.com/video/1179935060 Video for Parents (Español)]

[https://www.medscape.com/viewarticle/anesthetic-risk-linked-venezuelan-maternal-lineage-2026a10009ni?ecd=a2a&form=fpf Anesthetic Risk Linked to Venezuelan Maternal Lineage]

[https://journals.lww.com/monitor/fulltext/2026/03000/airs_case_2026_03__this_is_why_we_have_airs.10.aspx AIRS Case 2026-03: This Is Why We Have AIRS]

[https://www.apsf.org/article/perioperative-practices-for-patients-of-venezuelan-ancestry/ Perioperative Practices for Patients of Venezuelan Ancestry]

[https://sphere.nyssa-pga.org/2026/mitochondrial-genetic-susceptibility-to-anesthetics-in-patients-with-venezuelan-heritage/ Mitochondrial Genetic Susceptibility to Anesthetics in Patients with Venezuelan Heritage]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/hidden_in_the_haplotype__how_sevoflurane_may.5.aspx Hidden in the Haplotype: How Sevoflurane May Trigger Neurologic Injury in Adults and Children]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/ancient_mitochondrial_genetic_variant,_modern_day.7.aspx/ EDITORIAL:
Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

Sanz-Pons J, Aladrén-Herrer C, Ortigoza-Escobar JD: Effects of a mitochondrial genetic variant on sevoflurane hypersensitivity. Anesthesiology 2026; 144:1286–98

Dehydrogenase Deficiency

[https://pubmed.ncbi.nlm.nih.gov/25069536/ Anesthetic agents in patients with very long-chain acyl-coenzyme A dehydrogenase deficiency: a literature review]

[https://pubmed.ncbi.nlm.nih.gov/27896927/ A retrospective review of anesthesia and perioperative care in children with medium-chain acyl-CoA dehydrogenase deficiency]

[https://pubmed.ncbi.nlm.nih.gov/22608595/ Perioperative management of a pediatric patient with short-chain acyl-CoA dehydrogenase deficiency]

Mitochondrial Disease

2026-05-12T14:55:17Z

WikiSysop:

{{Stub Notice}}

See also: [[Leigh’s Syndrome]]

[https://pubmed.ncbi.nlm.nih.gov/27885500/ A review of anaesthetic outcomes in patients with genetically confirmed mitochondrial disorders]

[https://med.stanford.edu/content/dam/sm/pedsanesthesia/documents/mitochondrial-disease.pdf Mitochondrial Disease and Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/33591116/ Anesthetic Hypersensitivity in a Case-Controlled Series of Patients With Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/25503498/ Diagnosis and management of mitochondrial disease: a consensus statement from the Mitochondrial Medicine Society]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.12158 Anesthetic considerations in patients with mitochondrial defects]

[https://pubmed.ncbi.nlm.nih.gov/33752971/ Hypoxia ameliorates brain hyperoxia and NAD(+) deficiency in a murine model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/26917594/ Hypoxia as a therapy for mitochondrial disease]

[https://www.openanesthesia.org/vodcasts/anesthetic-considerations-in-patients-with-mitochondrial-disease/ Open Anesthesia: Anesthetic Considerations in Patients with Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/23923677/ Mitochondrial diseases and anesthesia: a literature review of current opinions]

[https://pubmed.ncbi.nlm.nih.gov/23007905/ Anesthesia for children with mitochondrial disorders: a national survey and review]

[https://pubmed.ncbi.nlm.nih.gov/32574972/ Sevoflurane as opposed to propofol anesthesia preserves mitochondrial function and alleviates myocardial ischemia/reperfusion injury]

Perioperative management of a child with short-chain acyl CoA dehydrogenase deficiency.
Pediatr Anesth 2005; 15: 771-7.

Hsieh VC, Krane EJ, Morgan PG. Mitochondrial disease and anesthesia. JIEMS. 2017;5:1–5

Kishikawa J-I, Inoue Y, Fujikawa M, Nishimura K, Nakanishi A, Tanabe T, et al. General anesthetics cause mitochondrial dysfunction and reduction of intracellular ATP levels. PLoS ONE. 2018;13:e0190213. doi: 10.1371/journal.pone.0190213

[https://pmc.ncbi.nlm.nih.gov/articles/PMC5278534 Anesthetic Management of a Child With Unspecified Mitochondrial Disease in an Outpatient Dental Setting]

[https://journals.lww.com/anesthesiology/abstract/2026/04000/effects_of_isoflurane_inhibition_of_mitochondrial.23.aspx Effects of Isoflurane Inhibition of Mitochondrial Complex I on Calcium Removal in Mouse Neuronal Cultures]

MT-ND4

[https://www.asahq.org/advocating-for-you/genetic-anesthesia-neurologic-mortality-risks ASA Information Page]

[https://journals.lww.com/anesthesiology/fulltext/9900/potential_mitochondrial_pharmacogenetic.904.aspx Potential Mitochondrial Pharmacogenetic Susceptibility to Severe Neurologic Events after General Anesthesia: Report from the Chilean Ministry of Health]
:[https://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=9900&issue=00000&article=00979&type=Fulltext Editorial: Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

[https://medlineplus.gov/genetics/gene/mt-nd4/ MT-ND4 gene: mitochondrially encoded NADH dehydrogenase 4]

[https://pedsanesthesia.net/forum/viewtopic.php?t=1352 Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children(Forum thread)]

[https://www.clinsurgeryjournal.com/index.php/ascr/article/view/ascr-aid1091/pdf Short Communication:Mitochondrial Genetic Susceptibility to Anesthetic Neurotoxicity in Venezuelan Pediatric Patients: A Call for Vigilance and Further Research]

[https://pedsanesthesia.org/joint-communication-from-the-society-for-pediatric-anesthesia-and-american-society-of-anesthesiologists-regarding-severe-neurological-complications-and-death-after-general-anesthesia-in-venezuelan-chi/ Joint Communication from the Society for Pediatric Anesthesia and American Society of Anesthesiologists Regarding Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children]

[https://youtu.be/cKuFfUwxSx4?si=v-WqKAO5gQerTKwu Part of the webinar series Hot Topics in Pediatric Anesthesia, presented by the Pediatric Anesthesia Committee of the Florida Society of Anesthesiologists, Rosalie Tassone, MD, Chair. "Bad Outcomes in Strange Times - Update on the ASA/SPA Communications Regarding Pediatric Patients of Venezuelan Families" presented by Luis Rodriguez, MD (originally presented on November 12, 2025)]

[https://www.asahq.org/advocating-for-you/guidance/asa-spa-neurological Update regarding severe neurological complications and death after general anesthesia in adult and pediatric patients of Venezuelan ancestry (January 27, 2026)]

[https://www.pnas.org/doi/10.1073/pnas.1621511114 Hypoxia treatment reverses neurodegenerative disease in a mouse model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/37770252/ Volatile anaesthetic toxicity in the genetic mitochondrial disease Leigh syndrome]

[https://journals.lww.com/anesthesiology/abstract/9900/effects_of_a_mitochondrial_genetic_variant_on.912.aspx Effects of a mitochondrial genetic variant on sevoflurane hypersensitivity]

[https://esaic.org/joint-statement-on-anaesthesia-related-mitochondrial-pharmacogenetic-risk-in-individuals-with-venezuelan-maternal-ancestry/ ESAIC News: Joint Statement on Anaesthesia-Related Mitochondrial Pharmacogenetic Risk in Individuals with Venezuelan Maternal Ancestry]

[https://kevinmd.com/2026/04/how-a-hidden-genetic-mutation-creates-a-severe-pediatric-anesthesia-risk.html KevinMD: How a hidden genetic mutation creates a severe pediatric anesthesia risk]

[https://revistachilenadeanestesia.cl/revchilanestv55n2-18/ Recomendaciones anestésicas frente a una variante genética infrecuente en población con ascendencia venezolana, con posible asociación a complicaciones neurológicas severas tras anestesia general (Anesthetic recommendations regarding a rare genetic variant in a population with Venezuelan ancestry, with a possible association with severe neurological complications following general anesthesia]

[https://www.sciencedirect.com/science/article/abs/pii/S0034935626000708 Encefalopatía aguda asociada a anestesia general en un paciente adulto portador de la variante m.11232T>C en el gen MT-ND4 (An adult case of acute encephalopathy associated with general anesthesia and the m.11232T>C MT-ND4 variant)]

[https://tools.sodapdf.com/document/6287485d-7db3-42e5-90c2-8f668e846b4a Emerging Reports of Severe Neurological Complications Following General Anesthesia in Patients with Maternal Venezuelan Ancestry]

[https://player.vimeo.com/video/1179934920 Video for Parents (English)]

[https://player.vimeo.com/video/1179935060 Video for Parents (Español)]

[https://www.medscape.com/viewarticle/anesthetic-risk-linked-venezuelan-maternal-lineage-2026a10009ni?ecd=a2a&form=fpf Anesthetic Risk Linked to Venezuelan Maternal Lineage]

[https://journals.lww.com/monitor/fulltext/2026/03000/airs_case_2026_03__this_is_why_we_have_airs.10.aspx AIRS Case 2026-03: This Is Why We Have AIRS]

[https://www.apsf.org/article/perioperative-practices-for-patients-of-venezuelan-ancestry/ Perioperative Practices for Patients of Venezuelan Ancestry]

[https://sphere.nyssa-pga.org/2026/mitochondrial-genetic-susceptibility-to-anesthetics-in-patients-with-venezuelan-heritage/ Mitochondrial Genetic Susceptibility to Anesthetics in Patients with Venezuelan Heritage]

[https://journals.lww.com/anesthesiology/fulltext/2026/06000/ancient_mitochondrial_genetic_variant,_modern_day.7.aspx/ EDITORIAL:
Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

Dehydrogenase Deficiency

[https://pubmed.ncbi.nlm.nih.gov/25069536/ Anesthetic agents in patients with very long-chain acyl-coenzyme A dehydrogenase deficiency: a literature review]

[https://pubmed.ncbi.nlm.nih.gov/27896927/ A retrospective review of anesthesia and perioperative care in children with medium-chain acyl-CoA dehydrogenase deficiency]

[https://pubmed.ncbi.nlm.nih.gov/22608595/ Perioperative management of a pediatric patient with short-chain acyl-CoA dehydrogenase deficiency]

The Making of Medical Malpractice Suit

2026-05-11T12:19:50Z

WikiSysop:

{{Stub Notice}}

[https://jamanetwork.com/journals/jama/article-abstract/379886 Medical Malpractice Experience of Physicians Predictable or Haphazard?]

[https://www.nejm.org/doi/pdf/10.1056/NEJMsa1506137 Prevalence and Characteristics of Physicians Prone to Malpractice Claims]

[https://pubmed.ncbi.nlm.nih.gov/7966867/ Obstetricians' prior malpractice experience and patients' satisfaction with care]

[https://pubmed.ncbi.nlm.nih.gov/7966868/ The relationship between malpractice claims history and subsequent obstetric care]

[https://pubmed.ncbi.nlm.nih.gov/18183762/ Identifying and addressing communication failures as a means of reducing unnecessary malpractice claims]

[https://pubmed.ncbi.nlm.nih.gov/7911925/ Why do people sue doctors? A study of patients and relatives taking legal action]

[https://www.anesthesiologynews.com/Multimedia/Article/10-25/What-to-Do-When-a-Patient-Claims-Harm/78710 Anesthesiologu News: What to Do When a Patient Claims Harm]

[https://pubmed.ncbi.nlm.nih.gov/1740858/ Factors that prompted families to file medical malpractice claims following perinatal injuries]

[https://pubmed.ncbi.nlm.nih.gov/8147552/ Characteristics of potential plaintiffs in malpractice litigation]

[https://pubmed.ncbi.nlm.nih.gov/16037100/ Patient perspectives of patient-provider communication after adverse events]

[https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-9566.2008.01131.x Practising Open Disclosure: clinical incident communication and systems improvement]

[https://www.alllaw.com/articles/nolo/medical-malpractice/standard-of-care.html What is the "Standard of Care" in a Medical Malpractice Case?]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.15685 Litigation related to anaesthesia]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15687 It's time to eliminate tort from the management of medical mishaps]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15729 Medicolegal claims: a way to learn from our mistakes?]

[https://pubmed.ncbi.nlm.nih.gov/24446943/ Supporting second victims of patient safety events: shouldn't these communications be covered by legal privilege?]

[https://pubmed.ncbi.nlm.nih.gov/21848463/ Malpractice risk according to physician specialty]

[https://pubmed.ncbi.nlm.nih.gov/2366968/ Preparing for a deposition]

[https://pubs.asahq.org/monitor/article/87/11/15/139324/Closed-Claims-Case-Review-Case-2023-11 Closed Claims Case Review Case 2023-11: Unanticipated Outcome after Peripheral Nerve Block: Role for Communication and Consent]

[https://pubmed.ncbi.nlm.nih.gov/36312452/ Protecting the Airway and the Physician: Lessons from 214 Cases of Endotracheal Intubation Litigation]

[https://pedsanesthesia.org/physician-litigation-support-resource-list/ SPA:Physician Litigation Support Resource List]

[https://www.ncbi.nlm.nih.gov/books/NBK436001/#:~:text=A%20medical%20expert's%20opinion%20should,the%20plaintiff%20or%20the%20defendant. StatPearls: Expert Witness]

[https://www.acepnow.com/article/several-states-protect-physicians-who-apologize-but-be-careful/ Several States Protect Physicians Who Apologize, But Be Careful]

[https://journals.lww.com/monitor/fulltext/2024/12000/help,_i_ve_been_sued__a_practical_guide_to_dealing.5.aspx Help, I've Been Sued! A Practical Guide to Dealing with a Lawsuit]

[https://pubs.asahq.org/monitor/article/88/12/25/142273/When-Malpractice-Happens-to-Good-Anesthesiologists When Malpractice Happens to Good Anesthesiologists]

[https://substack.com/redirect/23b81482-40da-41fc-86ea-e6bd3c0c186d?j=eyJ1IjoiZzN3ZHIifQ.qTapMyyaGoLaN-pPMR6akyeWgEThS7FxuNEdQS4GtzY Podcast: Doctors and Litigation: The L Word Podcast…]

[https://pedsanesthesia.org/physician-litigation-support-resource-list/ SPA Website Litigation Support]

[https://journals.lww.com/monitor/fulltext/2025/05000/a_medicolegal_primer_for_anesthesiologists.16.aspx ASA Monitor: A Medicolegal Primer for Anesthesiologists]

[https://www.asahq.org/advocating-for-you/safehaven ASA Safehaven Program]

[https://www.asahq.org/standards-and-practice-parameters/statement-on-expert-witness-qualifications-and-testimony ASA: Statement on Expert Witness Qualifications and Testimony]

[https://www.anesthesiologynews.com/Multimedia/Article/10-25/What-to-Do-When-a-Patient-Claims-Harm/78710 What to Do When a Patient Claims Harm (Anesthesiology News Multimedia)]

Preoperative Fasting

2026-05-11T12:04:33Z

WikiSysop:

{{Stub Notice}}

NPO

Guidelines:

[https://pubs.asahq.org/anesthesiology/article/138/2/132/137508/2023-American-Society-of-Anesthesiologists 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration—A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting*]

[https://link.springer.com/article/10.1007/s12630-023-02509-z 2023 Canadian Pediatric Anesthesia Society Statement on fasting for elective pediatric anesthesia]

[https://pubs.asahq.org/anesthesiology/article/126/3/376/19733/Practice-Guidelines-for-Preoperative-Fasting-and Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration]

[https://pubmed.ncbi.nlm.nih.gov/39773771/ Reviewing "Nil Per Os" Guidance for Clear Fluids in Children Before Anesthesia: Survey of the Pediatric Anesthesia Leadership Council]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15179 Guideline on anaesthesia and sedation in breastfeeding women 2020]

[https://pubmed.ncbi.nlm.nih.gov/29452803/ Preoperative fasting in children: review of existing guidelines and recent developments]

[https://pubmed.ncbi.nlm.nih.gov/34857682/ The rationale for the recommendations of the European Paediatric Fasting Guideline: Improving paediatric anaesthesia and perioperative medicine]

[https://pubmed.ncbi.nlm.nih.gov/34857683/ Pre-operative fasting in children: A guideline from the European Society of Anaesthesiology and Intensive Care]

[https://www.bjanaesthesia.org/article/S0007-0912(25)00215-6/fulltext Impact of liberal preoperative clear fluid fasting regimens on the risk of pulmonary aspiration in children (EUROFAST): an international prospective cohort study]

[https://pubs.asahq.org/anesthesiology/article/133/3/523/108227/Preoperative-Fluid-Fasting-Times-and-Postinduction Preoperative Fluid Fasting Times and Postinduction Low Blood Pressure in Children: A Retrospective Analysis]

[https://www.uptodate.com/contents/preoperative-fasting-in-children-and-infants?search=preoperative-fasting-in+children_and_infants&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1 UpToDate: Preoperative fasting in children and infants]

[https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2766509 Fluid Fasting in Children: Solid Science?]

https://bjanaesthesia.org/article/S0007-0912(21)00111-2/fulltext

[https://link.springer.com/article/10.1007/s12630-019-01382-z Canadian Pediatric Anesthesia Society statement on clear fluid fasting for elective pediatric anesthesia]

https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2766011

[https://ronlitman.substack.com/p/npo-guidelines-are-they-bubbameisters?r=g3wdr&utm_campaign=post&utm_medium=email&utm_source=copy From PAAD]

[https://www.bjaed.org/article/S2058-5349(17)30168-3/fulltext Preoperative fasting in children]

[https://link.springer.com/content/pdf/10.1007/s12630-019-01382-z.pdf Canadian Pediatric Anesthesia Society statement on clear fluid fasting for elective pediatric anesthesia]

[https://pubs.asahq.org/anesthesiology/article/127/4/A15/19790/Anesthesia-amp-Breastfeeding-More-Often-Than-Not Anesthesia & Breastfeeding: More Often Than Not, They Are Compatible]

[https://pubs.asahq.org/anesthesiology/article/134/6/A21/115725/Ultrasound-Insights-into-Neonatal-Fasting-Get-in Ultrasound Insights into Neonatal Fasting: Get in the NP-Know]

[https://pubmed.ncbi.nlm.nih.gov/29624435/ ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15751 The thirst for improvement: ensuring shorter and safer pre-operative fasting times in children]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14479 Effect of a carbohydrate lollipop on the gastric volume of fasted pediatric patients]

[https://pubmed.ncbi.nlm.nih.gov/36557062/ Relationship between Fasting Times and Emergence Delirium in Children Undergoing Magnetic Resonance Imaging under Sedation]

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517287/ Acute Intraoperative Pulmonary Aspiration]

[https://pubmed.ncbi.nlm.nih.gov/40410101/ Impact of liberal preoperative clear fluid fasting regimens on the risk of pulmonary aspiration in children (EUROFAST): an international prospective cohort study ] [https://pubmed.ncbi.nlm.nih.gov/40818914/ Comment]

Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017 Mar;126(3):376-393.

Frykholm P, Disma N, Andersson H, Beck C, Bouvet L, Cercueil E, Elliott E, Hofmann J, Isserman R, Kaucane A, Kuhn F, de Queiroz Siqueira M, Rosen D, Rudolph D, Schmidt AR, Schmitz A, Stocki D, Sumpelmann R, Stricker PA, Thomas M, Veyckemans F, Afshari A. Preoperative fasting in children: guideline from the European Society of Anaesthesiology and Intensive Care. Eur J Anaesthesiol 2022; 39:4–25.

Disma N, Frykholm P, Cook-Sather SD, Lerman J. Pro-con debate: 1- vs. 2-hour fast for clear liquids before anesthesia in children. Anesth Anal 2021; 133:581-91.

[https://link.springer.com/article/10.1007/s12630-023-02526-y Determining residual gastric volume in healthy children using ultrasound]

[https://pubmed.ncbi.nlm.nih.gov/35881513/ Ultrasound Assessment of Gastric Fluid Volume in Children Scheduled for Elective Surgery After Clear Fluid Fasting for 1 Versus 2 Hours: A Randomized Controlled Trial]

Joshi GP, Abdelmalak BB, Weigel WA, et al. 2023 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting: Carbohydrate-containing Clear Liquids with or without Protein, Chewing Gum, and Pediatric Fasting Duration-A Modular Update of the 2017 American Society of Anesthesiologists Practice Guidelines for Preoperative Fasting. Anesthesiology. Feb 1 2023;138(2):132-151. doi:10.1097/aln.0000000000004381

Frykholm P, Disma N, Andersson H, et al. Pre-operative fasting in children: A guideline from the European Society of Anaesthesiology and Intensive Care. European journal of anaesthesiology. Jan 1 2022;39(1):4-25. doi:10.1097/eja.0000000000001599

Sarhan KA, Hasaneen H, Hasanin A, Mohammed H, Saleh R, Kamel A. Ultrasound Assessment of Gastric Fluid Volume in Children Scheduled for Elective Surgery After Clear Fluid Fasting for 1 Versus 2 Hours: A Randomized Controlled Trial. Anesthesia and analgesia. Apr 1 2023;136(4):711-718. doi:10.1213/ane.0000000000006157

Yaster M, Galinkin J, Schreiner M. An Introduction to the Ethical Design, Conduct, and Analysis of Pediatric Clinical Trials. In: Andropolous D, Gregory G, eds. Gregory's Pediatric Anesthesia. 6th ed. Wiley-Blackwell; 2020:56-74:chap 4.

Roberts RB, Shirley MA. Reducing the risk of acid aspiration during cesarean section. Anesthesia and analgesia. Nov-Dec 1974;53(6):859-68. doi:10.1213/00000539-197453060-00010

DM, Rocke DA, Brock-Utne JG, Marszalek A, Engelbrecht HE. Critical volume for pulmonary acid aspiration: reappraisal in a primate model. British journal of anaesthesia. Aug 1990;65(2):248-50. doi:10.1093/bja/65.2.248

[https://www.hindawi.com/journals/grp/2015/497176/ Contrasting Perspectives of Anesthesiologists and Gastroenterologists on the Optimal Time Interval between Bowel Preparation and Endoscopic Sedation]

[https://aspenjournals.onlinelibrary.wiley.com/doi/10.1002/jpen.2556 Pre-Procedural Fasting Policies for Patients Receiving Tube Feeding: A National Survey]

[https://www.bjanaesthesia.org/article/S0007-0912(23)00563-9/fulltext Incidence of adverse respiratory events after adjustment of clear fluid fasting recommendations to 1 h: a prospective, observational, multi-institutional cohort study]

[https://pubs.asahq.org/monitor/article/88/4/19/139952/Perioperative-Tube-Feedings-Common-Questions Perioperative Tube Feedings – Common Questions]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2024/04000/preoperative_renin_angiotensin_system_antagonists.12.aspx Preoperative Renin-Angiotensin System Antagonists Intake and Blood Pressure Responses During Ambulatory Surgical Procedures: A Prospective Cohort Study]

[https://www.bjaopen.org/article/S2772-6096(24)00026-1/fulltext Preoperative fasting and the risk of pulmonary aspiration—a narrative review of historical concepts, physiological effects, and new perspectives]

[https://aci.health.nsw.gov.au/networks/anaesthesia-perioperative-care/resources/sip-til-send Sip Til Send]

[https://journals.lww.com/monitor/fulltext/2025/03000/staying_the_two_hour_course_on_pediatric_fasting.18.aspx Staying the Two-Hour Course on Pediatric Fasting Before Elective Surgery]

Kelly C, Walker R. Perioperative pulmonary aspiration is infrequent and low risk in pediatric anesthetic practice. Paediatr Anaesth.2015;25:36-43.18.

Warner MA, Warner ME, Warner DO, et al. Perioperative pulmonary aspiration in infants and children. Anesthes. 1999;90:66-71.

[https://www.bjanaesthesia.org/article/S0007-0912(25)00223-5/fulltext Preoperative fasting in paediatric anaesthesia: a movie with a predicable ending]

[https://pubmed.ncbi.nlm.nih.gov/29077812/ Gastric emptying for liquids of different compositions in children]

[https://academic.oup.com/bja/article-abstract/114/3/477/263029 Gastric pH and residual volume after 1 and 2 h fasting time for clear fluids in children]

[https://www.bjanaesthesia.org/article/S0007-0912(25)00902-X/abstract Driving change in fasting guidelines in a risk-averse environment: survey of current UK approaches and the infant milk fasting initiative]

GLP-1 agonists/analogs

[https://www.anzca.edu.au/getContentAsset/0f35028e-e371-4220-a49a-ddee877051c8/80feb437-d24d-46b8-a858-4a2a28b9b970/Periprocedural-GLP-1-use-consensus-clinical-guide_P2.pdf Clinical Practice Recommendations regarding patients taking GLP-1 receptor agonists and dual GLP-1/GIP receptor co-agonists prior to anaesthesia or sedation for surgical and endoscopic procedures]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16601 Association between glucagon-like peptide-1 receptor agonist use and peri-operative pulmonary aspiration: a systematic review and meta-analysis]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000005174/141932/Association-between-Glucagon-Like-Peptide-1 Association between Glucagon-like Peptide-1 Receptor Agonists and Aspiration Pneumonia during Endoscopic Procedures]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16306 Glucagon-like peptide-1 receptor agonists: a narrative review of clinical pharmacology and implications for peri-operative practice]

[https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients (Adults and Children) on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists]

[https://auckland.figshare.com/articles/preprint/Association_between_glucagon-like_peptide-1_receptor_agonists_residual_gastric_content_and_bronchopulmonary_aspiration_after_fasting_an_ongoing_systematic_review_and_meta-analysis/28537307?file=62206637 Association between glucagon-like peptide-1 receptor agonists, residual gastric content, and bronchopulmonary aspiration after fasting: an ongoing systematic review and meta-analysis]

[https://journals.lww.com/anesthesia-analgesia/abstract/2026/04000/assessment_of_gastric_content_using_gastric.6.aspx Assessment of Gastric Content Using Gastric Ultrasound in Patients on Glucagon-Like Peptide-1 Receptor Agonists Before Anesthesia]

Arcuri L. GLP-1 Drugs and the physiology of metabolic health. The Physiologist Magazine. American Physiological Society; 2026.

Moiz A, Filion KB, Toutounchi H, Tsoukas MA, Yu OHY, Peters TM, Eisenberg MJ. Efficacy and safety of glucagon-like peptide-1 receptor agonists for weight loss among adults without diabetes: a systematic review of randomized controlled trials. Ann Intern Med. 2025;178(2):199–217. doi:10.7326/ANNALS-24-01590.

McGuire DK, Marx N, Mulvagh SL, Deanfield JE, Inzucchi SE, Pop-Busui R, Mann JFE, Emerson SS, Poulter NR, Engelmann MDM, et al. Oral semaglutide and cardiovascular outcomes in high-risk type 2 diabetes. N Engl J Med. 2025;392(20):2001–2012.

Gastric Ultrasound

[https://pubmed.ncbi.nlm.nih.gov/25495405/ Ultrasound assessment of gastric volume in the fasted pediatric patient undergoing upper gastrointestinal endoscopy: development of a predictive model using endoscopically suctioned volumes]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16454 Relationship between residual gastric content and peri-operative semaglutide use assessed by gastric ultrasound: a prospective observational study]

[https://pubmed.ncbi.nlm.nih.gov/25495405/ Ultrasound assessment of gastric volume in the fasted pediatric patient undergoing upper gastrointestinal endoscopy: development of a predictive model using endoscopically suctioned volumes]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16117 Pre-operative gastric ultrasound in patients at risk of pulmonary aspiration: a prospective observational cohort study]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16190 Editorial: Point-of-care gastric ultrasound: food for thought]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.13555 Can we use ultrasound examination of gastric content as a diagnostic test in clinical anaesthesia?]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.70129 Gastric ultrasound in patients receiving semaglutide: a prospective, multicentre, matched control study]

Diabetes

2026-05-11T12:03:49Z

WikiSysop:

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[https://pubmed.ncbi.nlm.nih.gov/31688079/ Perioperative management of pediatric patients with type 1 diabetes mellitus, updated recommendations for anesthesiologists]

[https://pedsanesthesia.net/wiki/images/0/06/Periop_Insulin_Pump_Guidelines.pdf Perioperative Insulin Pump Guidelines (Protocol)]

[https://resources.wfsahq.org/atotw/sglt-2-receptor-inhibitors/ SGLT-2 Receptor Inhibitors: Pharmacology and Anaesthetic Implications]

[https://pubmed.ncbi.nlm.nih.gov/30637935/ ISPAD clinical practice consensus guidelines 2018: management of children and adolescents with diabetes requiring surgery]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000004776/139420/ASA-Consensus-based-Guidance-on-Preoperative ASA Consensus-based Guidance on Preoperative Management of Patients on Glucagon-like Peptide-1 Receptor Agonists]

[https://www.bjaed.org/article/S2058-5349(24)00049-0/fulltext Update on the perioperative management of diabetes mellitus]

[https://www.openanesthesia.org/keywords/perioperative-management-of-patients-with-type-1-diabetes-mellitus/ Open Anesthesia: Perioperative Management of Patients with Type 1 Diabetes Mellitus]

[https://www.openanesthesia.org/keywords/glucose-homeostasis-and-insulin-therapy/ Open Anesthesia: Glucose Homeostasis and Insulin Therapy]

[https://pubmed.ncbi.nlm.nih.gov/39151135/ Impact of Intraoperative Dexamethasone on Perioperative Blood Glucose Levels: Systematic Review and Meta-Analysis of Randomized Trials]

[https://pubmed.ncbi.nlm.nih.gov/38995851/ Navigating Advanced Diabetes Technologies in Perioperative Practice: A Survey of Pediatric Anesthesiologists]

[https://www.openanesthesia.org/keywords/perioperative-management-of-patients-with-type-1-diabetes-mellitus/ Perioperative Management of Patients with Type 1 Diabetes Mellitus]

[https://pubmed.ncbi.nlm.nih.gov/38995851/ Navigating Advanced Diabetes Technologies in Perioperative Practice: A Survey of Pediatric Anesthesiologists]

[https://pubmed.ncbi.nlm.nih.gov/31688079/ Perioperative Management of Pediatric Patients With Type 1 Diabetes Mellitus, Updated Recommendations for Anesthesiologists]

Kapellen T, Agwu JC, Martin L, et al. ISPAD clinical practice consensus guidelines 2022: Management of children and adolescents with diabetes requiring surgery. Pediatr Diabetes 2022; 23(8): 1468-77.

Vanderhoek SM, Moini A, Prichett L, Wolf RM. Practice patterns of perioperative insulin pump management in pediatric diabetes. Paediatric anaesthesia 2021; 31(7): 827-9.

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000005174/141932/Association-between-Glucagon-Like-Peptide-1 Association between Glucagon-like Peptide-1 Receptor Agonists and Aspiration Pneumonia during Endoscopic Procedures]

[https://resources.wfsahq.org/atotw/new-antiobesity-medications/ New Antiobesity Medications, GLP-1, and GIP Receptor Agonists and their Anaesthetic Implications]

[https://resources.wfsahq.org/atotw/perioperative-management-of-diabetic-patients-optimising-care-with-insulin-pumps-and-cgm-devices/ Perioperative Management of Diabetic Patients: Optimising Care with Insulin Pumps and CGM Devices]

[https://pubs.asahq.org/anesthesiology/article/141/6/1141/142136/Perioperative-Management-of-Patients-Taking Perioperative Management of Patients Taking Glucagon-like Peptide-1 Receptor Agonists: Applying Evidence to Clinical Practice]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2025/01000/perioperative_care_of_patients_using_wearable.2.aspx Perioperative Care of Patients Using Wearable Diabetes Devices]

[https://pubmed.ncbi.nlm.nih.gov/37724489/ Error traps in the perioperative management of children with type 1 diabetes]

[https://www.asahq.org/about-asa/newsroom/news-releases/2024/10/new-multi-society-glp-1-guidance Most Patients Can Continue Diabetes, Weight Loss GLP-1 Drugs Before Surgery, Those at Highest Risk for GI Problems Should Follow Liquid Diet Before Procedure]

[https://pubmed.ncbi.nlm.nih.gov/26784129/ Direct Evidence of Acetaminophen Interference with Subcutaneous Glucose Sensing in Humans: A Pilot Study]

[https://pubmed.ncbi.nlm.nih.gov/28332406/ Continuous Glucose Monitor Interference With Commonly Prescribed Medications: A Pilot Study]

[https://pubmed.ncbi.nlm.nih.gov/39884260/ International Society for Pediatric and Adolescent Diabetes Clinical Practice Consensus Guidelines 2024 Diabetes Technologies: Glucose Monitoring]

[https://pubmed.ncbi.nlm.nih.gov/38517760/ Society for Ambulatory Anesthesia Updated Consensus Statement on Perioperative Blood Glucose Management in Adult Patients With Diabetes Mellitus Undergoing Ambulatory Surgery]

[https://www.sciencedirect.com/science/article/pii/S0889852925000040 Diabetic Ketoacidosis]

Arcuri L. GLP-1 Drugs and the physiology of metabolic health. The Physiologist Magazine. American Physiological Society; 2026.

Moiz A, Filion KB, Toutounchi H, Tsoukas MA, Yu OHY, Peters TM, Eisenberg MJ. Efficacy and safety of glucagon-like peptide-1 receptor agonists for weight loss among adults without diabetes: a systematic review of randomized controlled trials. Ann Intern Med. 2025;178(2):199–217. doi:10.7326/ANNALS-24-01590.

McGuire DK, Marx N, Mulvagh SL, Deanfield JE, Inzucchi SE, Pop-Busui R, Mann JFE, Emerson SS, Poulter NR, Engelmann MDM, et al. Oral semaglutide and cardiovascular outcomes in high-risk type 2 diabetes. N Engl J Med. 2025;392(20):2001–2012.

Mitochondrial Disease

2026-05-11T11:59:10Z

WikiSysop:

{{Stub Notice}}

See also: [[Leigh’s Syndrome]]

[https://pubmed.ncbi.nlm.nih.gov/27885500/ A review of anaesthetic outcomes in patients with genetically confirmed mitochondrial disorders]

[https://med.stanford.edu/content/dam/sm/pedsanesthesia/documents/mitochondrial-disease.pdf Mitochondrial Disease and Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/33591116/ Anesthetic Hypersensitivity in a Case-Controlled Series of Patients With Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/25503498/ Diagnosis and management of mitochondrial disease: a consensus statement from the Mitochondrial Medicine Society]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.12158 Anesthetic considerations in patients with mitochondrial defects]

[https://pubmed.ncbi.nlm.nih.gov/33752971/ Hypoxia ameliorates brain hyperoxia and NAD(+) deficiency in a murine model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/26917594/ Hypoxia as a therapy for mitochondrial disease]

[https://www.openanesthesia.org/vodcasts/anesthetic-considerations-in-patients-with-mitochondrial-disease/ Open Anesthesia: Anesthetic Considerations in Patients with Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/23923677/ Mitochondrial diseases and anesthesia: a literature review of current opinions]

[https://pubmed.ncbi.nlm.nih.gov/23007905/ Anesthesia for children with mitochondrial disorders: a national survey and review]

[https://pubmed.ncbi.nlm.nih.gov/32574972/ Sevoflurane as opposed to propofol anesthesia preserves mitochondrial function and alleviates myocardial ischemia/reperfusion injury]

Perioperative management of a child with short-chain acyl CoA dehydrogenase deficiency.
Pediatr Anesth 2005; 15: 771-7.

Hsieh VC, Krane EJ, Morgan PG. Mitochondrial disease and anesthesia. JIEMS. 2017;5:1–5

Kishikawa J-I, Inoue Y, Fujikawa M, Nishimura K, Nakanishi A, Tanabe T, et al. General anesthetics cause mitochondrial dysfunction and reduction of intracellular ATP levels. PLoS ONE. 2018;13:e0190213. doi: 10.1371/journal.pone.0190213

[https://pmc.ncbi.nlm.nih.gov/articles/PMC5278534 Anesthetic Management of a Child With Unspecified Mitochondrial Disease in an Outpatient Dental Setting]

[https://journals.lww.com/anesthesiology/abstract/2026/04000/effects_of_isoflurane_inhibition_of_mitochondrial.23.aspx Effects of Isoflurane Inhibition of Mitochondrial Complex I on Calcium Removal in Mouse Neuronal Cultures]

MT-ND4

[https://www.asahq.org/advocating-for-you/genetic-anesthesia-neurologic-mortality-risks ASA Information Page]

[https://journals.lww.com/anesthesiology/fulltext/9900/potential_mitochondrial_pharmacogenetic.904.aspx Potential Mitochondrial Pharmacogenetic Susceptibility to Severe Neurologic Events after General Anesthesia: Report from the Chilean Ministry of Health]
:[https://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=9900&issue=00000&article=00979&type=Fulltext Editorial: Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

[https://medlineplus.gov/genetics/gene/mt-nd4/ MT-ND4 gene: mitochondrially encoded NADH dehydrogenase 4]

[https://pedsanesthesia.net/forum/viewtopic.php?t=1352 Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children(Forum thread)]

[https://www.clinsurgeryjournal.com/index.php/ascr/article/view/ascr-aid1091/pdf Short Communication:Mitochondrial Genetic Susceptibility to Anesthetic Neurotoxicity in Venezuelan Pediatric Patients: A Call for Vigilance and Further Research]

[https://pedsanesthesia.org/joint-communication-from-the-society-for-pediatric-anesthesia-and-american-society-of-anesthesiologists-regarding-severe-neurological-complications-and-death-after-general-anesthesia-in-venezuelan-chi/ Joint Communication from the Society for Pediatric Anesthesia and American Society of Anesthesiologists Regarding Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children]

[https://youtu.be/cKuFfUwxSx4?si=v-WqKAO5gQerTKwu Part of the webinar series Hot Topics in Pediatric Anesthesia, presented by the Pediatric Anesthesia Committee of the Florida Society of Anesthesiologists, Rosalie Tassone, MD, Chair. "Bad Outcomes in Strange Times - Update on the ASA/SPA Communications Regarding Pediatric Patients of Venezuelan Families" presented by Luis Rodriguez, MD (originally presented on November 12, 2025)]

[https://www.asahq.org/advocating-for-you/guidance/asa-spa-neurological Update regarding severe neurological complications and death after general anesthesia in adult and pediatric patients of Venezuelan ancestry (January 27, 2026)]

[https://www.pnas.org/doi/10.1073/pnas.1621511114 Hypoxia treatment reverses neurodegenerative disease in a mouse model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/37770252/ Volatile anaesthetic toxicity in the genetic mitochondrial disease Leigh syndrome]

[https://journals.lww.com/anesthesiology/abstract/9900/effects_of_a_mitochondrial_genetic_variant_on.912.aspx Effects of a mitochondrial genetic variant on sevoflurane hypersensitivity]

[https://esaic.org/joint-statement-on-anaesthesia-related-mitochondrial-pharmacogenetic-risk-in-individuals-with-venezuelan-maternal-ancestry/ ESAIC News: Joint Statement on Anaesthesia-Related Mitochondrial Pharmacogenetic Risk in Individuals with Venezuelan Maternal Ancestry]

[https://kevinmd.com/2026/04/how-a-hidden-genetic-mutation-creates-a-severe-pediatric-anesthesia-risk.html KevinMD: How a hidden genetic mutation creates a severe pediatric anesthesia risk]

[https://revistachilenadeanestesia.cl/revchilanestv55n2-18/ Recomendaciones anestésicas frente a una variante genética infrecuente en población con ascendencia venezolana, con posible asociación a complicaciones neurológicas severas tras anestesia general (Anesthetic recommendations regarding a rare genetic variant in a population with Venezuelan ancestry, with a possible association with severe neurological complications following general anesthesia]

[https://www.sciencedirect.com/science/article/abs/pii/S0034935626000708 Encefalopatía aguda asociada a anestesia general en un paciente adulto portador de la variante m.11232T>C en el gen MT-ND4 (An adult case of acute encephalopathy associated with general anesthesia and the m.11232T>C MT-ND4 variant)]

[https://tools.sodapdf.com/document/6287485d-7db3-42e5-90c2-8f668e846b4a Emerging Reports of Severe Neurological Complications Following General Anesthesia in Patients with Maternal Venezuelan Ancestry]

[https://player.vimeo.com/video/1179934920 Video for Parents (English)]

[https://player.vimeo.com/video/1179935060 Video for Parents (Español)]

[https://www.medscape.com/viewarticle/anesthetic-risk-linked-venezuelan-maternal-lineage-2026a10009ni?ecd=a2a&form=fpf Anesthetic Risk Linked to Venezuelan Maternal Lineage]

[https://journals.lww.com/monitor/fulltext/2026/03000/airs_case_2026_03__this_is_why_we_have_airs.10.aspx AIRS Case 2026-03: This Is Why We Have AIRS]

[https://www.apsf.org/article/perioperative-practices-for-patients-of-venezuelan-ancestry/ Perioperative Practices for Patients of Venezuelan Ancestry]

[https://sphere.nyssa-pga.org/2026/mitochondrial-genetic-susceptibility-to-anesthetics-in-patients-with-venezuelan-heritage/ Mitochondrial Genetic Susceptibility to Anesthetics in Patients with Venezuelan Heritage]

Dehydrogenase Deficiency

[https://pubmed.ncbi.nlm.nih.gov/25069536/ Anesthetic agents in patients with very long-chain acyl-coenzyme A dehydrogenase deficiency: a literature review]

[https://pubmed.ncbi.nlm.nih.gov/27896927/ A retrospective review of anesthesia and perioperative care in children with medium-chain acyl-CoA dehydrogenase deficiency]

[https://pubmed.ncbi.nlm.nih.gov/22608595/ Perioperative management of a pediatric patient with short-chain acyl-CoA dehydrogenase deficiency]

Combined Spinal/Caudal

2026-05-07T16:11:40Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/38828972/ Awake Combined Spinal Caudal Anesthesia for Longer-Duration Urologic Surgery in Infants: A Case Series]

[https://pubmed.ncbi.nlm.nih.gov/31085139/ Combined spinal/caudal catheter anesthesia: extending the boundaries of regional anesthesia for complex pediatric urological surgery]

[https://pubmed.ncbi.nlm.nih.gov/17897271/ Combined spinal-epidural anesthesia in major abdominal surgery in high-risk neonates and infants]

[https://www.apicareonline.com/index.php/APIC/article/view/1037#pkp_content_main Combined spinal and caudal epidural anesthesia for ureteral reimplantation in pediatric patients: a case series]

Caudal

2026-05-07T15:57:58Z

WikiSysop:

{{Stub Notice}}

= Caudal Epidural Block in Pediatric Anesthesia =

== Overview and Anatomy ==

[https://pubmed.ncbi.nlm.nih.gov/28337460/ Caudal Epidural Block: An Updated Review of Anatomy and Techniques]

[https://pubmed.ncbi.nlm.nih.gov/29028948/ Volumes of the spinal canal and caudal space in children zero to three years of age assessed by magnetic resonance imaging: implications for volume dosage of caudal blockade]

[https://pubmed.ncbi.nlm.nih.gov/19922508/ The prevalence of anatomical variations that can cause inadvertent dural puncture when performing caudal block in Koreans: a study using magnetic resonance imaging]

[https://pubmed.ncbi.nlm.nih.gov/23515954/ The level of termination of the dural sac by MRI and its clinical relevance in caudal epidural block in adults]

[https://pubmed.ncbi.nlm.nih.gov/28332251/ Measuring the depth of the caudal epidural space to prevent dural sac puncture during caudal block in children]

[https://www.youtube-nocookie.com/embed/2d4Ct4nmU7A?rel=0&autoplay=0&showinfo=0&enablejsapi=0 RAAPM: Ultrasound Guided Caudal Block]

[[TYK5 |Test Your Knowledge]]: newborn spinal cord

== Techniques and Guidance ==
[https://pubmed.ncbi.nlm.nih.gov/16682915/ Caudal anesthesia in pediatrics: an update]

[https://pubmed.ncbi.nlm.nih.gov/30829666/ Real-Time Ultrasound Improves Accuracy of Caudal Block in Children]

[https://pubmed.ncbi.nlm.nih.gov/34752689/ Comparative evaluation of landmark technique and ultrasound-guided caudal epidural injection in pediatric population: A systematic review and meta-analysis]

[https://pubmed.ncbi.nlm.nih.gov/32267040/ Confirmation of success rate of landmark-based caudal blockade in children using ultrasound: A prospective analysis]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15738 Ultrasound-guided caudal blockade and sedation for paediatric surgery: a retrospective cohort study]

[https://journals.lww.com/aacr/fulltext/2024/10000/real_time_ultrasonography_for_the_placement_of.7.aspx Real-Time Ultrasonography for the Placement of Caudal Epidurals for Thoracic Surgery in Infants: A Description of the Technique and Case Series]

[https://www.openanesthesia.org/vodcasts/caudal-epidural-anesthesia-in-pediatric-patients/?search_term=caudal Caudal Epidural Anesthesia in Pediatric Patients OA-SPA Pediatric Anesthesia Virtual Grand Rounds]

[https://onlinelibrary.wiley.com/doi/full/10.1046/j.1460-9592.2000.00442.x?saml_referrer Tunnelling of caudal epidural catheters in infants]

[[File:Caudal-Kulkarni.jpeg|467x467px]]

== Dosing, Volume, and Drug Comparisons ==
[https://pubmed.ncbi.nlm.nih.gov/37429622/ Reconsidering injection volume for caudal epidural block in young pediatric patients: a dynamic flow tracking experimental study]

[https://pubmed.ncbi.nlm.nih.gov/19762734/ A comparison of high volume/low concentration and low volume/high concentration ropivacaine in caudal analgesia for pediatric orchiopexy]

[https://onlinelibrary.wiley.com/doi/full/10.1046/j.1460-9592.2000.00532.x Comparison of ropivacaine 0.1% and 0.2% with bupivacaine 0.2% for single-shot caudal anaesthesia in children]

[https://journals.lww.com/sjan/fulltext/2017/11040/ultrasound_assessment_of_cranial_spread_during.13.aspx Ultrasound assessment of cranial spread during caudal blockade in children: Effect of different volumes of local anesthetic]

[https://pubmed.ncbi.nlm.nih.gov/12032008/ The minimum local anesthetic concentration of ropivacaine for caudal analgesia in children]

[https://www.pedspainmedicine.org/wp-content/uploads/newsletters/2020/fall/Update%20PRA/local%20anesthetic.html Choice of Local Anesthetic Agent for Epidural Infusions in Neonates and Infants: The Case for Chloroprocaine]

== Adjuncts and Additives ==
[https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1460-9592.1996.d01-3.x The use of additives to local anaesthetic solutions for caudal epidural blockade]

[https://pubmed.ncbi.nlm.nih.gov/29479931/ Dexmedetomidine as an adjunct for caudal anesthesia and analgesia in children]

[https://pubmed.ncbi.nlm.nih.gov/27755489/ The Use of Epinephrine in Caudal Anesthesia Increases Stroke Volume and Cardiac Output in Children]

== Monitoring and Physiologic Effects ==
[https://pubmed.ncbi.nlm.nih.gov/16884465/ The effects of caudal local anesthesia blockade on the Bispectral Index during general anesthesia in children]

[https://pubmed.ncbi.nlm.nih.gov/9187777/ Detection of intravascular injection of regional anaesthetics in children]

== Outcomes and Safety ==
[https://pubmed.ncbi.nlm.nih.gov/25393589/ Are caudal blocks for pain control safe in children? an analysis of 18,650 caudal blocks from the Pediatric Regional Anesthesia Network (PRAN) database]

[https://pubmed.ncbi.nlm.nih.gov/22696610/ Pediatric Regional Anesthesia Network (PRAN): a multi-institutional study of the use and incidence of complications of pediatric regional anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/30264660/ A Systematic Review of Caudal Anesthesia and Postoperative Outcomes in Pediatric Cardiac Surgery Patients]

== Special Populations and Conditions ==
[https://pubmed.ncbi.nlm.nih.gov/17040315/ Caudal anesthesia in children with shunt devices]

[https://onlinelibrary.wiley.com/doi/10.1111/j.1460-9592.2007.02200.x Caudal block and ventricular shunt devices: beware of the consequences of increasing epidural pressure!]

[https://pubmed.ncbi.nlm.nih.gov/38498665/ Tethered Spinal Cord Syndrome Discovered during Ultrasound-guided Caudal Block]

[https://pubmed.ncbi.nlm.nih.gov/22338610/ Ultrasonography reveals a high prevalence of lower spinal dysraphism in children with urogenital anomalies]

[https://pubmed.ncbi.nlm.nih.gov/35115413/ Ultrasound determination of the dural sac to sacrococcygeal membrane distance in premature neonates]

== Hypospadias and Urologic Surgery ==
[https://pubmed.ncbi.nlm.nih.gov/28585401/ Caudal analgesia, hypospadias, and urethrocutaneous fistula: Does association mean causality?]

[https://pubmed.ncbi.nlm.nih.gov/33617329/ Caudal Blocks and Hypospadias Repair Complications-Much Ado about Nothing or the Real Deal?]

[https://pubmed.ncbi.nlm.nih.gov/37002025/ Caudal anesthesia is not associated with post-operative complications following distal hypospadias repair]

[https://pubmed.ncbi.nlm.nih.gov/?term=caudal%20hypospadias Search: caudal & hypospadias]

[https://pubmed.ncbi.nlm.nih.gov/2884900/ Comparison of caudal and ilioinguinal/iliohypogastric nerve blocks for control of post-orchiopexy pain in pediatric ambulatory surgery]

== Complications and Case Reports ==
[https://pubmed.ncbi.nlm.nih.gov/23144440/ Case report: neurological complications associated with epidural analgesia in children: a report of 4 cases of ambiguous etiologies]

== Summary ==
* (Optional section for synthesis, conclusions, or optinon references)

== What should an anesthesiologist tell a parent of a child getting a caudal block? ==
An anesthesiologist should inform a parent of a child receiving a caudal block about the procedure, potential risks, benefits, and what to expect. They might say:

* 1. Explanation of the procedure: Describe that a caudal block is a type of regional anesthesia that involves injecting medication near the lower end of the spine to numb the lower half of the body.
* 2. Purpose: Explain the purpose of the caudal block, which is often to provide pain relief during and after a surgical procedure in the lower part of the body.
* 3. Benefits: Discuss the potential benefits, such as reduced pain and discomfort during and after the surgery.
* 4. Risks: Mention possible risks, including infection, bleeding, nerve damage, and allergic reactions to the medication.
* 5. Anesthesia process: Describe how the child will receive the anesthesia and what monitoring will be in place to ensure their safety.
* 6. Pre-operative instructions: Provide any necessary pre-operative instructions, such as fasting guidelines, and answer any questions the parent may have.
* 7. Recovery: Explain the expected recovery process, including the duration of pain relief and any potential side effects or limitations.
* 8. Address concerns: Be receptive to any concerns or questions the parent may have, and provide reassurance as needed.
* 9. Consent: Ensure that the parent understands the procedure and its risks and benefits and obtain their informed consent.
* 10. Follow-up: Discuss the importance of post-operative follow-up and what to do if they have questions or concerns after the procedure.

It's essential for the anesthesiologist to maintain open communication, address parental concerns, and provide information in a clear and compassionate manner.

Advanced Airway Techniques

2026-05-07T15:27:15Z

WikiSysop:

{{Stub Notice}}

== Guidelines/General Approaches ==
[https://pubmed.ncbi.nlm.nih.gov/34762729/ 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway]

[https://www.ncbi.nlm.nih.gov/pubmed/30861424 The pediatric airway: Historical concepts, new findings, and what matters.]

[https://bjanaesthesia.org/article/S0007-0912(21)00176-8/fulltext BJA: Difficult airway management: children are different from adults, and neonates are different from children!]

[https://onlinelibrary.wiley.com/toc/14609592/2020/30/3 Pediatric Anesthesia: Special Issue:Pediatric Airway Special Issue]

[https://www.anesthesiologynews.com/download/Congenital_ANSE0720_WM.pdf The Congenital Difficult Airway in Pediatrics]

[https://www.nejm.org/doi/full/10.1056/NEJMra1916801/ NEJM: Management of the Difficult Airway]

[https://www.karger.com/Article/Fulltext/481979 The Laryngeal Mask Airway and Its Use in Neonatal Resuscitation: A Critical Review of Where We Are in 2017/2018]

== Emergency Response ==
[https://apps.apple.com/us/app/pedi-crisis-2-0/id1409734476 Pedi Crisis 2.0 - application]

:[[Difficult Airway Response Teams]]

== Videolaryngoscopy ==
[https://pubmed.ncbi.nlm.nih.gov/42080668/ Airway Management in Neonates and Young Infants: Changes in Clinical Outcomes With Adoption of Routine Video Laryngoscopy in a Single Center Retrospective Cohort]

[https://link.springer.com/article/10.1007/s12630-021-02162-4 Video laryngoscopy 2.0]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00065-5/abstract Comparison of tracheal intubation conditions between the operating room and intensive care unit: impact of universal videolaryngoscopy]

[https://www.nejm.org/doi/full/10.1056/NEJMoa2402785 Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infants]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16394 Prospective development and validation of a universal classification for paediatric videolaryngoscopic tracheal intubation: the PeDiAC score]

[https://pubmed.ncbi.nlm.nih.gov/39907265/ Availability and Practice Patterns of Videolaryngoscopy and Adaptation of Apneic Oxygenation in Pediatric Anesthesia: A Cross-Sectional Survey of Pediatric Anesthesiologists]

[https://journals.lww.com/ejanaesthesiology/fulltext/2026/03000/universal_videolaryngoscopy__between_current.16.aspx Universal videolaryngoscopy: between current evidence and ethical imperatives]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16704 Assessing the incidence of `can see, cannot intubate easily´during routine use of C-MAC videolaryngoscopy]

== Fiberoptic Laryngoscopy ==
[https://www.youtube.com/watch?v=oO2aSOYMKDg Fiberoptic Intubation Air-Q SGA with Continuous Ventilation by Jim DuCanto]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000004431/137372/Difficult-Airway-Management-in-Neonates-Fiberoptic Difficult Airway Management in Neonates: Fiberoptic Intubation via Laryngeal Mask Airway]

[https://pubmed.ncbi.nlm.nih.gov/11915066/ Airway regional anesthesia for awake fiberoptic intubation]

== Light Wand ==
[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.1979.tb06379.x ‘Light wand’ intubation]

[https://pubmed.ncbi.nlm.nih.gov/28470901/ A simple homemade lighted stylet for neonates and infants: a description and case report of its use in an infant with the Pierre Robin anomalad]

== Bougie/Stylet ==
[https://pubmed.ncbi.nlm.nih.gov/18211445/ Intubation of infants with Pierre Robin syndrome: the use of the paraglossal approach combined with a gum-elastic bougie in six consecutive cases]

[https://pubmed.ncbi.nlm.nih.gov/15505469/ The Eschmann Tracheal Tube Introducer Is Not Gum, Elastic, or a Bougie]

== Cricothyrotomy/FONA ==
[https://pubmed.ncbi.nlm.nih.gov/22313556/ Emergency surgical cricothyroidotomy: 24 successful cases leading to a simple 'scalpel-finger-tube' method]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14796 Emergency front-of-neck access in infants: A pragmatic crossover randomized control trial comparing two approaches on a simulated rabbit model]

[https://pubmed.ncbi.nlm.nih.gov/39381516 An exploration of the cognitive and affective processes for anaesthetists when performing an emergency front of neck airway]

[https://onlinelibrary.wiley.com/doi/full/10.1111/pan.14875 Emergency front-of-neck access in pediatric anesthesia: A narrative review]

The trachea heals but the hypoxia does not' an emergency front-of-neck access in a 4-year-old with foreign body airway obstruction. European journal of anaesthesiology 2025, 42(10):945–947.

Emergency front-of-neck access: Lessons from a real-world CICO case. European journal of anaesthesiology 2025, 42(10):863–865.

Emergency front of neck access in airway management. BJA Educ 2019, 19(8):246–253.

Haag AK, Tredese A, Bordini M, et al. Emergency front-of-neck access in pediatric anesthesia: A narrative review. Paediatr Anaesth 2024;34(6):495–506. (In eng). DOI: 10.1111/pan.14875.

Morais D, Cordeiro A, Rego S. Frova Introducer in Anesthesiology: Friend or Foe? Cureus 2025;17(8):e90723. DOI: 10.7759/cureus.90723.

Eckmann DM, Seligman I, Coté CJ, Hussong JW. Mucormycosis supraglottitis on induction of anesthesia in an immunocompromised host. Anesth Analg 1998;86(4):729–30. (In eng). DOI: 10.1097/00000539-199804000-00010.

Coté CJ, Eavey RD, Todres ID, Jones DE. Crocothyroid membrane puncture: oxygenation and ventilation in a dog model using an intravenous catheter. Crit Care Med 1988;16:615–619.

Lyons C, Callaghan M. Uses and mechanisms of apnoeic oxygenation: a narrative review. Anaesthesia 2019;74(4):497–507. DOI: https://doi.org/10.1111/anae.14565.

Slutsky AS, Brown R. Cardiogenic oscillations: a potential mechanism enhancing oxygenation during apneic respiration. Med Hypotheses 1982;8(4):393–400. (In eng). DOI: 10.1016/0306-9877(82)90032-9.

Goldstein B, Shannon DC, Todres ID. Supercarbia in children: clinical course and outcome. Crit Care Med 1990;18(2):166–8. DOI: 10.1097/00003246-199002000-00008.

Coté CJ, Hartnick CJ. Pediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children? Paediatr Anaesth 2009;19 Suppl 1:66–76. DOI: 10.1111/j.1460-9592.2009.02996.x.

[https://www.sciencedirect.com/science/article/pii/S2772609625001509 A protocol for an emergency front-of-neck airway registry in the United Kingdom]

[https://journals.lww.com/anesthesiology/citation/2026/04000/rediscovering_retrograde_intubation__a_classic_but.29.aspx Rediscovering Retrograde Intubation: A Classic but Indispensable Technique in the Era of Video Laryngoscopy]

== Complications ==
[https://pubs.asahq.org/anesthesiology/article/135/3/495/116017/Dramatic-Cervical-Spine-Injury-Secondary-to Dramatic Cervical Spine Injury Secondary to Videolaryngoscopy in a Patient Suffering from Ankylosing Spondylitis]

== Non-OR Airway Management ==
[https://picudoconcall.org/?captivate_podcast=11 Management of High Risk Intubations in the PICU | picudoconcall.org]

[https://pubmed.ncbi.nlm.nih.gov/36841658/ The Pediatric Bougie for the First Tracheal Intubation Attempt in Critically Ill Children]

== Communication ==
[https://onlinelibrary.wiley.com/doi/10.1111/pan.14760 The role of WhatsApp™ in pediatric difficult airway management: A study from the PeDI Collaborative]

== Specific Situations ==
[https://bjaed.org/article/S2058-5349(20)30032-9/pdf Paediatric adenotonsillectomy (considerations for anaesthesia), part 1]
[https://bjaed.org/article/S2058-5349(20)30033-0/pdf part 2]

[https://www.anesthesiologynews.com/Review-Articles/Article/08-19/10-Common-Pediatric-Airway-Problems-And-Their-Solutions/55657?sub=D0CBDA824FBCB7AA4A61CCDE9984A8F4D0A8A95B29CEB0A1653EDA6256BD25&enl=true&dgid=&utm_source=enl&utm_content=2&utm_campaign=20200801&utm_medium=button AnesNews: 10 Common Pediatric Airway Problems—And Their Solutions]

[https://bjanaesthesia.org/article/S0007-0912(21)00116-1/fulltext Difficult tracheal intubation in neonates and infants. (NECTARINE)]

[https://pubmed.ncbi.nlm.nih.gov/21789701/ A new modification for safer submental orotracheal intubation]

[http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-33472020000200091 Submental intubation in pediatric maxillofacial surgery: report of 2 cases]

[https://pubmed.ncbi.nlm.nih.gov/26919822/ Lignocaine topicalization of the pediatric airway]

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10720842/ Airway management in neonates and infants]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16290 Airway management in patients with suspected or confirmed cervical spine injury]

[https://journals.lww.com/anesthesia-analgesia/abstract/2025/02000/awake_supraglottic_airway_placement_in_pediatric.13.aspx Awake Supraglottic Airway Placement in Pediatric Patients for Airway Obstruction or Difficult Intubation: Insights From an International Airway Registry (PeDI)]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14322 A modified adjustable oral RAE microcuff® endotracheal tube]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2044.1991.tb09315.x?sid=nlm%3Apubmed Accidental bronchial intubation with RAE tubes]

Apneic Oxygenation

[https://pubmed.ncbi.nlm.nih.gov/38030551/ Apnoeic oxygenation during paediatric tracheal intubation: a systematic review and meta-analysis]

[https://pubmed.ncbi.nlm.nih.gov/38065762/ Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines]

[https://pubmed.ncbi.nlm.nih.gov/34762729/ 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway]

[https://pubmed.ncbi.nlm.nih.gov/29699900/ Apneic oxygenation reduces hypoxemia during endotracheal intubation in the pediatric emergency department]

[https://pubmed.ncbi.nlm.nih.gov/36650568/ Effect of apneic oxygenation with intubation to reduce severe desaturation and adverse tracheal intubation-associated events in critically ill children]

[https://pubmed.ncbi.nlm.nih.gov/24838096/ Safe oxygen saturation targeting and monitoring in preterm infants: can we avoid hypoxia and hyperoxia? Acta]

Rehman MA, Schreiner MS. Oral and nasotracheal light wand guided intubation after failed fibreoptic bronchoscopy. Paediatric anaesthesia 1997;7(4):349-51. (In eng). DOI: 10.1046/j.1460-9592.1997.d01-85.x.

[https://pubmed.ncbi.nlm.nih.gov/8467551/ Difficult laryngoscopy made easy with a "BURP"]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16366 Universal paediatric videolaryngoscopy and glottic view grading: a prospective observational study]

[https://www.bjaed.org/article/S2058-5349(24)00092-1/abstract Teaching and training advanced airway management]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00505-1/abstract Optimal McGRATH® MAC videolaryngoscope blade size for small children]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16366 Universal paediatric videolaryngoscopy and glottic view grading: a prospective observational study]

[https://resources.wfsahq.org/atotw/use-of-supraglottic-airways-sgas-as-rescue-devices-conduits-for-tracheal-intubation-ti-and-other-special-cases/ WFSA Tutorial: Use of Supraglottic Airways (SGAs) as Rescue Devices, Conduits for Tracheal Intubation (TI), and Other Special Cases]

[https://www.sciencedirect.com/science/article/pii/S000709122500279X Incidence of cognitive errors in difficult airway management: an inference human factors study from the Pediatric Difficult Intubation Registry]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16705 Consensus recommendations for paediatric airway topicalisation using lidocaine]

[https://www.bjanaesthesia.org/article/S0007-0912(25)00279-X/fulltext Incidence of cognitive errors in difficult airway management: an inference human factors study from the Pediatric Difficult Intubation Registry]

[https://www.bjanaesthesia.org/article/S0007-0912(25)00340-X/fulltext Cognitive errors in paediatric difficult airway management: a step into the unknown]

[https://www.bjaopen.org/article/S2772-6096(25)00040-1/fulltext Ethical decision making in airway management: a Difficult Airway Society position statement on good practice]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16731 Implementation of default videolaryngoscopy instead of direct laryngoscopy for tracheal intubation: a narrative review of evidence and experiences]

Bai W., P. Koppera, Y. Yuan, G. Mentz, B.Pearce, M. Therrian, P. Reynolds, S. E. S. Brown. Availability and Practice Patterns of Videolaryngoscopy and Adaptation of Apneic Oxygenation in Pediatric Anesthesia: A Cross-Sectional Survey of Pediatric Anesthesiologists. Paediatr Anaesth. 2025A; 35(6):460–468. DOI: 10.1111/pan.15079. Epub 2025 Feb 5.PMID: 39907265; PMCID: PMC12060081.

[https://journals.lww.com/anesthesiology/abstract/9900/high_flow_nasal_oxygenation_in_infants_undergoing.883.aspx High-Flow Nasal Oxygenation in Infants Undergoing Tracheal Intubation: A Single-center Randomized Controlled Trial]

[https://pubmed.ncbi.nlm.nih.gov/28393433/ Nasal high-flow oxygen delivery in children with abnormal airways]

Main Page

2026-05-07T15:12:40Z

WikiSysop: /* Airway Management */

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=Introductory Topics=
:[[Preface]]
:[[Disclaimer]]

:[[The Editing Team]]
:[[History of Pediatric Anesthesia]]
:[[Pediatric Anesthesia Worldwide]]
:[[Measuring Outcome in Pediatric Anesthesia]]
:[[Basic Pediatric Concepts]]

==Training/Education/Certification==
:[[The Making of a Pediatric Anesthesiologist]]
::[[Educational Principles]]
::[[Certification Processes]]
::[[The Anesthesia Workforce]]
::[[Transitioning to Practice]]
::[[Women in Anesthesia]]
::[[Transitioning to Retirement]]
:[[Certified Registered Nurse Anesthestists - CRNA]]
:[[Anaesthesia Associates - AA]]
:[[TYK About | Test Your Knowledge]]
:[[Managing Knowledge]]

==Basic Clinical Information [Outside Sources]==
:[[WFSA PaedsUpdateContents_30]] Volume 30 - June 2015 (Wiki Format)
:[[WFSA PaedsUpdateContents_37]] Volume 37 - October 2023 (Wiki Format) [https://www.dropbox.com/scl/fi/rdgiam3tv8jbzrsptdyoy/New-Update-37-Paediatrics.pdf?rlkey=unpir1ysnmx1xchwq7c3i0oxc&st=ttapqkxn&dl=0 (PDF Format)]
:[[WFSA PaedsUpdateContents_39]] [https://www.dropbox.com/scl/fi/he3ncg2uhwzdi91xh76ta/UIA-39-WORKFORCE-WELL-BEING.pdf?rlkey=y3alw1rxs7telzfdqjtadu6m7&st=y6gxzslh&dl=0 (PDF Format)]
:[https://www2.pedsanesthesia.org/lecture_series/ Society for Pediatric Anesthesia Lecture Series]
:[https://www.openanesthesia.org/ OpenAnesthesia]
:[https://learn.openpediatrics.org/pages/245/anesthesiology OpenPediatrics for Anesthesiology]
:[https://www.dropbox.com/scl/fi/uwlezdgx26ci6eddhnnba/Pediatric_20y_Comprehensive_Board_Review_-2015.pdf?rlkey=00d46xm9o68t7y4r8l0v35eu5&st=927c5vgv&dl=0 Pediatric Anesthesiology Comprehensive Board Review (Oxford)]
:ASA🔒 Resident Study Guides
::[https://education.asahq.org/mod/book/view.php?id=32940&chapterid=123 Peds Core Month One Curriculum]
::[https://education.asahq.org/mod/book/view.php?id=32940&chapterid=134 Peds Core Month 2 Curriculum]
::[https://education.asahq.org/mod/book/view.php?id=32940&chapterid=137 Peds Advanced Month 3 Curriculum]
:[[ABA Pediatric Anesthesiology Exam Content Outline]]

Textbooks
:[https://www.academia.edu/37973952/Manual_of_Pediatric_Anesthesia 📒 Practice of Anesthesia for Infants and Children, Seventh Edition (Lerman, Coté, Anderson)]

:[https://www.sciencedirect.com/book/9780323341257/smiths-anesthesia-for-infants-and-children 📒 Smith's Anesthesia for Infants and Children • Ninth Edition • 2017 (Davis and Cladis)]

:[https://monographs.ufs.ac.za/index.php/PASA/index 📒 Paediatric Anaesthesia for Southern Africa]

==The Growing Child==
:[[Embryology]]
:[[Development]]
:[[Growth]]
:[[Developmental Psychology]]

==Anatomy & Physiology==
:[[Respiratory System]]
:[[Cardiovascular System]]
:[[Renal System]]
:[[Endocrine System]]
:[[Nervous System]]
:[[Temperature Regulation]]
:[[Fluid & Electrolytes]]
:[[Coagulation & Bleeding]]
:[[Pharmacology]]
::[[Clinical Pharmacokinetics & Pharmacodynamics in children]]
::[[Anesthetic Agents]]
::[[Opiates & Sedatives]]
::[[Muscle Relaxants]]
:[[Epigenetics]]
:[[Infection Control]]
:[[Neurocognitive Risk]]

==Monitoring==
:[[Standard Monitoring]]
::[[Precordial Stethoscope]]
::[[Oxygen]]
::[[Electrocardiography - EKG]]
::[[Carbon Dioxide]]
::[[Blood Pressure]]
::[[Neuromuscular Blockade]]
::[[Temperature]]
:[[Neuromonitoring - IOM]]
:[[Thromboelastography - TEG]]
:[[Pacemakers]]
:[[Automated Internal Defibrillators]]
:[[Near-Infrared Spectroscopy]]
:[[Electroencephalography - EEG]]
:[[Precordial Doppler]]
:[[Depth of Anesthesia]]
::[[BIS]]
::[[SEDline]]
:[[Alarm Fatigue]]

==Ethical Issues in Pediatric Anesthesia==
:[[Ethical Constructs relevant to Pediatric Anesthesia]]
:[[The Emancipated Minor]]
:[[Assent/Consent]]
:[[The child of a Jehovah's Witness]]
:[[Anesthesia in Low Resource Settings]]
:[[Global Pediatric Anesthesia]]
:[[VIP Care]]
:[[End of Life]]
:[[Racial Disparities in Care]]
:[[Child Abuse, Neglect, and Protection]]

==Error, Judgement, and The Law==
:[[Errors in the Operating Room]]
::[[Wrong Side Procedures]]
:[[Just Culture]]
:[[The Making of Medical Malpractice Suit]]

=Clinical Techniques=
:[[Standards of Anesthesia]]
:[[Pocket Reference Cards]]
:[[Point of Care Ultrasound - POCUS]]
:[[Hypnosis]]
==Preoperative Assessment==
:[[General Preoperative Assessment]]
:[[Psychological Preparation of the Pediatric Patient & Family]]
:[[The Fetus]]
:[[The Pre-Term Infant]]
:[[The Infant]]
:[[The Child]]
:[[The Adolescent]]
:[[The Adult-aged Pediatric Patient]]
:[[The Former Premature Patient]]
:[[Upper Respiratory Infection]]
:[[Obstructive Sleep Apnea]]
:[[Preoperative Fasting]]
:[[Vaccination Status]]
:[[Child Trafficking]]
:[[Pregnancy Testing]]
:[[Social Determinants of Care]]
:[[Herbal Supplements]]

==Pre-anesthetic Medication==
:[[Pre-induction/Pre-medication]]

==Pediatric Sedation==
:[[Principles of Sedation]]
:[[Dental Sedation]]
:[[Sedation for Radiologic Procedures]]

==Ambulatory Anesthesia==
:[[Criteria for Outpatient Care]]
:[[Facility Requirements for Outpatient Care]]
:[[Risks/Advantages of Outpatient Care]]

==Anesthetic Induction==
:[[Physiology of Anesthesia]]
:[[Parental Presence During Induction]]
:[[Magic as a Distraction Technique]]
:[[Distracting Devices]]
:[[Psychological Preparation of the Pediatric Patient & Family]]

==Maintenance of Anesthesia==
:[[Fluid Management]]
:[[Neuromuscular Blockade]]
:[[Blood Products]]
::[[Massive Transfusion/Hemorrhage Protocol]]
::[[Reducing Blood Draw Anemia]]
::[[Blood Rheology]]
:[[Temperature Management]]
:[[Positioning]]
:[[Ventilation]]
::[[Breathing circuits]]
::[[Intraoperative Atelectasis]]
:[[Hypotension]]
::[[Controlled Hypotension]]
:[[Electrocautery]]
:[[Depth of Anesthesia]]
::[[BIS]]
::[[SEDline]]

Drugs
:[[Volatile Anesthetics]]
::[[Inhalational Induction]]
::[[Closed Circuit Anesthesia]]
::[[High Altitude Effects]]
:[[Propofol]]
:[[Dexmedetomidine]]
:[[Opiates]]
:[[Opioid Free Techniques]]
:[[Target Controlled Infusion - TCI]]
:[[Hypnosis]]
:[[Non-Steroidal Anti-inflammatory Agents]]
::[[Ketorolac]]
::[[Ibuprofen]]
::[[Cox-2 Inhibitors]]
:[[Ketamine]]
:[[Esmolol]]
:[[Adenosine]]
:[[Benzodiazepines]]
:[[Perioperative Steroids]]
:[[Antibiotics]]
:[[Acetaminophen]]
:[[Methylene Blue]]
:[[Insulin Pumps]]
:[[Parasympatholytics]]
:[[Bicarbonate]]
:[[Succinylcholine]]
:[[Antihistamines]]
:[[Rubber Coring]]

==Emergence/Recovery from Anesthesia==
:[[Deep Extubation]]
:[[Emergence Delirium]]
:[[Post Operative Nausea & Vomiting]]
:[[Pain Management in the Recovery Room]]
:[[Post Obstructive Pulmonary Edema]]
:[[Intraoperative Awareness and Recall]]
:[[Post Operative Apnea]]
:[[Early Mobilization]]

==Airway Management==
:[[Basic Airway Anatomy of the Pediatric Patient]]
:[[Syndromes and Airway Assessment]]
:[[Basic Airway Management of the Pediatric Patient]]
:[[Laryngeal Mask Airway]]
:[[Basic Laryngoscopy and Intubation]]
:[[Basic Nasal Intubation]]

:[[Rapid Sequence Induction]]

:[[Recognizing and Managing the Difficult Pediatric Airway]]

:[[Advanced Airway Techniques]]
:[[Airway POCUS]]

:[[Difficult Airway Response Teams]]
:[[One Lung Ventilation]]
:[[Cuffed vs Uncuffed ETTs]]

:[[Basic Ventilation]]
:[[Advanced Ventilation]]
:[[Emergency Airway Management]]
:[[Complications of Airway Management]]
:[[Intraoperative Atelectasis]]
:[[Laryngospasm]]
:[[Nebulization]]
:[[Extubation]]
:[[Deep Extubation]]

==Vascular Access==
:[[Intravenous catheter placement & Care]]
:[[Central Venous Catheter placement & Care]]
:[[Intraosseous Access & Care]]
:[[Arterial catheter placement & Care]]
:[[Intranasal Drug Delivery]]
:[[Needlestick Injury]]

==Regional Blockade==
:[[Principles of Regional Anesthesia in Children]]
:[[The use of Ultrasound for Regional Anesthesia]]
:[[Local Anesthetics in Children]]
::[[Topical Analgesics]]
:[[Local Anesthetic Adjuncts in Children]]
:[[Continuous Catheter Infusion (Outside of Hospital)]]
:[[Local Anesthetic Systemic Toxicity - LAST]]
:[[Nerve Complications of Regional Blockade]]
:[[Peripheral Nerve Stimulation]]
:[[Compartment Syndrome and Regional Blockade]]
:[[Post-Dural Puncture Headache]]
:[[Rebound Pain after Nerve Block]]
:[[Vasodilatory Effect of Blockade]]

Blocks:
:[[Axial Blockade]] ([[Caudal]], [[Lumbar Epidural]], [[Thoracic Epidural]], [[Spinal]], [[Combined Spinal/Caudal]])

:[[Head & Neck]] ([[Palatal]], [[Buccal]], [[Supraorbital & Trochlear Nerve Blocks]], [[Oral Nerve Blocks]], [[Superficial Cervical Plexus Block]], [[Suprazygomatic Maxillary Nerve]], [[Infraorbital Nerve Block]], [[Scalp Blocks]], [[Ophthalmic Blocks]])

:[[Upper Extremity]] ([[Interscalene]], [[Supraclavicular]], [[Infraclavicular]], [[Axillary]], [[Peripheral Arm]], [[Intravenous Regional (Bier)]])

:[[Thorax]] ([[Intercostal]], [[Paravertebral]], [[Erector Spinae Plane]], [[Pleural]], [[Pectoral]], [[Serratus Anterior]])

:[[Abdomen]] ([[Rectus Sheath]], [[Transversus Abdominus Plane]], [[Quadratus Lumborum]], [[Ileoinguinal/Ileohypogastric]], [[Pudendal]], [[Penile]])

:[[Lower Extremity]] ([[Lumbar Plexus]], [[PENG]], [[Femoral]], [[Adductor Canal]], [[4 in 1]], [[Sciatic]], [[Popliteal]], [[iPACK]], [[Ankle]])

==Blood Conservation Techniques==
:[[Cell Saver]]
:[[Controlled Hypotension]]
:[[Tranexamic Acid]]
:[[Reducing Blood Draw Anemia]]

==Cardiopulmonary Resuscitation==
:[[Intraoperative Cardiac Arrest]]
:[[Pediatric CPR]]
:[[Code Teams]]
:[[PALS Protocols]]
:[[Prone CPR]]
:[[ECMO]]
:[[CPR Coach]]
:[[Crisis Management]]
:[[Parental Presence During Resuscitation / CPR]]
:[[Breaking Bad News]]

=Syndromes/Disorders=
[https://sites.uclouvain.be/anesthweekly/MRP_ENG/index.html Syndromes & Rare Diseases in Pediatrics: Anesthesia]

[https://rarediseases.info.nih.gov/diseases/browse-by-first-letter Genetic and Rare Diseases Information Center]

[https://www.ncbi.nlm.nih.gov/books/NBK430685/ StatPearls (National Library of Medicine)]

[https://www.orphananesthesia.eu/en/home-2.html OrphanAnesthesia]

:[[Achalasia]]
:[[Achondroplasia]]
:[[Acute Flaccid Myelitis]]
:[[Adrenal Insufficiency]]
:[[Alagille Syndrome]]
:[[Alpha-Gal Syndrome]]
:[[Anaphylaxis]]
:[[Anencephaly/Hydranencephaly]]
:[[Angelman Syndrome]]
:[[anti-NMDA receptor encephalitis]]
:[[Apert Syndrome]]
:[[Asthma]]
:[[Autism Spectrum]]
:[[Beckwith-Wiedemann syndrome]]
:[[Bronchopulmonary Dysplasia]]
:[[Brugada Syndrome]]
:[[Cardiac Tamponade]]
:[[Cardiomyopathy]]
:[[Cerebral Palsy]]
:[[CHARGE association]]
:[[Charcot-Marie-Tooth Disease]]
:[[Cleft lip and/or palate]]
:[[Cleidocranial dysplasia]]
:[[Cocaine Use]]
:[[Conjoined Twins]]
:[[Cornelia de Lange Syndrome]]
:[[COVID]]
:[[Craniosynostosis]]
:[[Croup]]
:[[Cystic Fibrosis]]
:[[DiGeorge syndrome (22q11.2 deletion syndrome)]]
:[[Diabetes]]
:[[Disseminated Intravascular Coagulation]]
:[[Down Syndrome]]
:[[Duchenne muscular dystrophy]]
:[[Early (J Point) Repolarization]]
:[[Ehlers-Danlos Syndrome]]
:[[Epidermolysis Bullosa]]
:[[Factor V Leiden]]
:[[Fanconi Anemia]]
:[[Fetal and Neonatal Arrhythmias]]
:[[Freeman-Sheldon Syndrome]]
:[[Genetic Disease]]
:[[G6PD]]
:[[Goldenhar syndrome]]
:[[Guillain–Barré syndrome]]
:[[Hereditary Angioedema]]
:[[Hereditary Spherocytosis]]
:[[Heterotaxy Syndrome]]
:[[Hiccups]]
:[[Inherited metabolic disorders]]
:[[Intrauterine Drug Exposure]]
:[[Kartagener's syndrome]]
:[[Ketogenic Diet]]
:[[Klippel-Feil syndrome]]
:[[Klippel-Trenaunay syndrome]]
:[[Leigh’s Syndrome]]
:[[Lennox-Gastaut syndrome]]
:[[Long QT Syndrome]]
:[[Malignant Hyperthermia]]
:[[Marijuana Use]]
:[[Mastocytosis]]
:[[Measles]]
:[[Medical Child Abuse]]
:[[Medium-chain acyl-CoA Dehydrogenase Deficiency]]
:[[Menkes Disease]]
:[[Mesenteric Traction Syndrome]]
:[[Minimal Change Disease]]
:[[Mitochondrial Disease]]
:[[Möbius syndrome]]
:[[Monkeypox]]
:[[Moya Moya Syndrome]]
:[[Mucopolysaccharidoses]]
:[[Myasthenia Gravis]]
:[[Myotonic dystrophies]]
:[[Nephrotic Syndrome]]
:[[Neuroleptic Malignant Syndrome]]
:[[Niemann-Pick Disease]]
:[[Nonaccidental Trauma]]
:[[Noonan syndrome]]
:[[Obesity]]
:[[Obstructive Sleep Apnea]]
:[[Ophthalmologic Disease]]
:[[Osteogenesis imperfecta]]
:[[Pacemakers]]
:[[Papillomatosis]]
:[[Patent Ductus Arteriosus]]
:[[Periodic Fever Syndromes]]
:[[Pheochromocytoma]]
:[[Pierre Robin sequence]]
:[[Polycythemia Vera]]
:[[Porphyria]]
:[[Postural orthostatic tachycardia syndrome (POTS)]]
:[[Prader-Willi Syndrome]]
:[[Priapism]]
:[[Pseudocholinesterase Deficiency]]
:[[Pulmonary Hypertension]]
:[[Red-Head (MC1R) variant]]
:[[Renal Agenesis]]
:[[Retinopathy of Prematurity]]
:[[Rett Syndrome]]
:[[Rubinstein-Taybi Syndrome]]
:[[Sepsis]]
:[[Sickle Cell Disease]]
:[[Smoking and Vaping]]
:[[Special Needs]]
:[[Spina Bifida]]
:[[Spinal Cord Injury]]
:[[Spinal Muscular Atrophy]]
:[[Stevens-Johnson Syndrome]]
:[[Stickler Syndrome]]
:[[Stroke]]
:[[Sturge Weber]]
:[[Substance Use Disorder]]
:[[Tetanus]]
:[[Thyrotoxicosis]]
:[[Treacher Collins syndrome]]
:[[Trochlear Palsey]]
:[[Tuberous Sclerosis]]
:[[Tumor Lysis Syndrome]]
:[[Turner syndrome]]
:[[VACTERR (or VACTERL) association]]
:[[Vein of Galen Malformation]]
:[[Venous Thromboembolism]]
:[[Von Hippel-Lindau Syndrome]]
:[[Von Willibrand’s Disease]]
:[[Waardenburg syndrome]]
:[[Williams Syndrome]]
:[[Wolff-Parkinson-White syndrome]]

=Procedure Based Discussions=
:[[Generalized Suggested Outline]]

==General Surgery==
:[[Appendectomy]]
:[[Bariatric]]
:[[Bronchoscopy]]
:[[Burns]]
:[[Button Battery Ingestion]]
:[[Central Line Placement (Hickman/Broviac/Infusaport)]]
:[[Chest Tube - Thoracentesis]]
:[[Cholelithiasis]]
:[[Cystic Adenomatous Malformation (CAM)]]
:[[Diaphragmatic Hernia]]
:[[Duodenal Atresia]]
:[[Gastrochisis]]
:[[Inguinal Hernia]]
:[[Kasai Procedure]]
:[[Laparoscopy]]
:[[Magnet Ingestion]]
:[[Malrotation]]
:[[Necrotizing Enterocolitis]]
:[[Neuroblastoma]]
:[[Omphalocoele]]
:[[Ovarian Torsion]]
:[[Pectus Excavatum/Carinatum]]
:[[Pheochromocytoma]]
:[[Pyloric Stenosis]]
:[[Sacrococcygeal Teratoma]]
:[[Thoracotomy]]
:[[Thymectomy]]
:[[Thyroid/Parathyroid]]
:[[Tracheo-Esophageal Fistula]]
:[[Tracheopexy]]
:[[Trauma]]
:[[Umbilical Hernia]]
:[[Umbilical Herniorrphy]]

==Transplant==
:[[Liver Transplant]]
:[[Renal Transplant]]
:[[Cardiac Transplant]]
:[[Organ Procurement]]

==Otolarngology/Head & Neck Surgery(ENT)==
:[[Auditory Evoked Potentials]]
:[[Bleeding Upper Airway]]
:[[Bone Anchored Hearing Aid (BAHA)]]
:[[Bronchoscopy]]
:[[Cricoid Split Procedure]]
:[[Drug-induced sleep endoscopy (DISE)]]
:[[Epiglottitis]]
:[[EXIT Procedure]]
:[[Foreign Body in Airway]]
:[[Glottic Web]]
:[[Hypoglossal Nerve Stimulators]]
:[[Laryngotracheal Reconstruction]]
:[[Mastoidectomy]]
:[[Myringotomy Tubes]]
:[[Papillomatosis]]
:[[Retropharyngeal Abscess]]
:[[Suspension Micro Laryngoscopy]]
:[[Thyroglossal Duct Cyst]]
:[[Tonsillectomy/Adenoidectomy]]
:[[Tracheostomy]]
:[[Vallecular Cyst]]

==Fetal==
:[[Fetal Interventions]]
:[[ex utero intrapartum treatment (EXIT)]]

==Dental/Oral Surgery==
:[[Dental Restoration]]
:[[Dental Extraction]]
:[[Dental Sedation]]

==Orthopedics==
:[[Idiopathic Scoliosis]]
:[[Neuromuscular Scoliosis]]
:[[Slipped Capital Femoral Epiphysis]]
:[[Upper Extremity Fracture]]
:[[Lower Extremity Fracture]]
:[[Bone Cement]]
:[[Compartment Syndrome]]
:[[Tourniquet Use]]
:[[Clubfoot Repair]]
:[[Total Knee Arthroplasty]]
:[[Anterior Cruciate Ligament Repair]]

==Neurosurgery==
:[[General Neurosurgery]]
:[[Brain Tumor Craniotomy]]
:[[Arnold Chiari Malformation]]
:[[Ventriculo-Peritoneal Shunt]]
:[[Spinal Cord Untethering]]
:[[Encephalocele]]
:[[Spinal Cord Injury]]
:[[Awake Craniotomy]]
:[[Vagal Nerve Stimulator]]
:[[Arteriovenous Malformation]]
:[[Traumatic Brain Injury]]
:[[Air Embolism]]
:[[Spina Bifida - Myelomeningocele]]
:[[Pituitary Surgery]]
:[[Craniosynostosis]]
:[[Tethered Cord]]
:[[Rhizotomy]]

==Plastics==
:[[Craniosynostosis]]
:[[Craniofacial Reconstruction]]
:[[Cleft lip and/or palate]]
:[[LeFort Advancement]]
:[[Pierre Robin Mandibular Distraction]]
:[[Septo-Rhinoplasty]]
:[[Dermatologic Laser Therapy]]

==Urology==
:[[Circumcision]]
:[[Inguinal Hernia]]
:[[Cystoscopy]]
:[[Hypospadias]]
:[[Ureteral Re-Implantation]]
:[[Bladder Augmentation]]
:[[Neonatal Exstrophy]]
:[[Testicular Torsion]]
:[[Orchiopexy]]
:[[Robotic Surgery]]

==Transgender Topics==
:[[Transgender Terminology]]
:[[Assessment of the Transgender Patient]]
:[[Gender Confirming Therapies]]
::[[Hormone Therapy]]
::[[Feminizing Procedures]]
::[[Masculinizing procedures]]
::[[Perioperative Care]]

==Ophthalmology==
:[[Strabismus]]
:[[Glacoma]]
:[[Retina]]
:[[Retinoblastoma]]
:[[Nasolacrimal Duct]]
:[[Ptosis]]
:[[Open Globe]]
:[[Orbital Trauma/Fracture]]

==Cardiac/Congenital Heart Disease==
:[[Basic Cardiac Principles]]
:[[Transitional Circulation]]
:[[Cyanotic Lesions]]
:[[Non-cyanotic Lesions]]
:[[Cardiopulmonary Bypass]]
:[[Cardiac Catheterization]]
:[[Non-Cardiac Procedures]]

==Gastroenterology==
:[[Upper Endoscopy]]
:[[Lower Endoscopy/Colonoscopy]]
:[[Endoscopic Retrograde Cholangio-Pancreaticogram]]
:[[Liver Biopsy]]

==Oncology==
:[[Perioperative Care of the Child with Cancer]]
:[[Lumbar Puncture]]
:[[Bone Marrow Aspirate/Biopsy]]
:[[Bone Marrow Harvest]]
:[[Anterior Mediastinal Mass]]
:[[Wilms’ Tumor]]
:[[Radiation Therapy]]

==Robotic Surgery==
:[[Principles/Physiology]]
:[[Urology]]
:[[Orthopedics]]
:[[General Surgery]]

==Maternal-Fetal==
:[[Introduction to Fetal Anesthesia]]
:[[Pre-Partum Procedures]]
:[[Ex utero intrapartum treatment (EXIT)]]

==Radiology==
:[[Interventional Radiology]]
::[[Gastic-Jejunal Feeding Tube Insertion]]
::[[Vascular/Lymphatic Malformation]]
::[[Whitaker Procedure]]
::[[Percutaneous Nephrostomy]]
::[[Endovascular Liver Biopsy]]
::[[Cyst Drainage]]

:[[Magnetic Resonance Imaging]]
::[[Head/Body]]
::[[Cardiac MRI]]
:[[Positron Emission Tomography (PET)]]

:[[Neuroradiology]]
::[[Wada Test]]
::[[Vein of Galen Malformation]]
::[[Ophthalmic Artery Injection]]

:[[Urodynamic Studies]]
:[[Varicocele]]

==Psychiatry==
:[[Electroconvulsive Therapy]]

==Pain Management==
:WFSA: [[Perioperative analgesic pharmacology in children]]
:[[Overview of Pain in Children]]
:[[Factors that Modulate Pediatric Pain]]
:[[Assessment of Pain in Children]]
:[[Multimodal Pain Management in Children]]
:[[Pain Treatment in Children]]
::[[Acute Pain]]
:::[[Surgical]]
:::[[Medical]]
::[[Chronic Pain]]
:::[[Acute Pain that Becomes Chronic]]
:::[[Surgical]]
:::[[Medical]]
:[[Patient/Nurse/Parent Controlled Analgesia]]
:[[Patient Controlled Epidural Anesthesia]]
:[[Cancer Pain]]
:[[Hypnosis]]
:[[Honey]]
:[[Pain Management in the Intensive Care Unit]]
:[[Cryoanalgesia]]

==Palliative Care==
:[[Principles of Pediatric Palliative Care]]
:[[Transitioning to Palliative Care]]
:[[Setting Goals]]
:[[Techniques in the Palliative Setting]]
:[[End of Life Care]]
:[[Futile Care]]

=Operational/Procedural Topics=

==Care of the Pediatric Anesthesiologist==
:[[Ergonomics and Physical Factors]]
:[[Psychologic Stress]]
:[[Imposter Syndrome]]
:[[Diversity, Equity, and Inclusion]]
:[[Clinical Decision-Making]]
:[[Performance and Compensation]]
:[[The Aging Anesthesiologist]]
:[[Academic Matters]]

==Operating Suite Design and Implementation==
:[[Medical Language Interpretation]]
:[[Pre-operative Evaluation Center]]
:[[Pre-operative In-Take]]
:[[Operating Room Design]]
:[[Post-anesthesia Care Unit]]
:[[Remote Anesthesia Locations]]
::[[Radiology]]
::[[Magnetic Resonance Suite]]
::[[Cardiac Catheterization]]
::[[Pet Scanner]]
::[[CT Scanner]]
::[[Emergency Department]]
::[[Office-based Practice]]
:[[Scheduling Strategies]]
:[[Environmental and Occupational Considerations]]
:[[Intraoperative Communication]]
:[[Personal Electronic Devices]]

==Sedation of the Pediatric Patient==
:[[Transporting the anesthetized Pediatric Patient]]
:[[Dental Sedation]]
:[[Creating a Sedation Service]]

==Recovery of the Pediatric Patient==
:[[Post Operative Nausea & Vomiting]]
:[[Pain Management in the Recovery Room]]
:[[Post-Operative Nursing Care]]
:[[Emergence Delirium]]
:[[Delayed Emergence]]
:[[Post-Operative Behavior Changes]]

==Personnel Safety in the Pediatric Environment==
:[[Operating Room Fires]]
:[[Active Shooter]]
:[[Magnetic Resonance Imaging - MRI]]
:[[X-Ray & Radiologic Safety]]

==Special Topics in Mass Casualty Incidents==

:[[Principles of MCI and Pediatrics]]

:[[Helicopter Emergency Medical Services- HEMS]]

==Low Resource Environments==
:[[Low Resource Environment Issues]]
:[[In-Flight Emergencies]]

==The Pediatric Perioperative Surgical Home==
:[[Enhanced Recovery After Surgery - ERAS]]
:
----

=Editing tools=
:[[TYK_Question_List]]
:[[Working Sandbox]]

Advanced Ventilation

2026-05-07T15:09:03Z

WikiSysop:

{{Stub Notice}}

[https://youtu.be/UyewbZmL9xQ Open Pediatrics: Therapies When Conventional Ventilation Fails]

[https://www.bjanaesthesia.org/article/S0007-0912(19)30849-9/fulltext Emergency front of neck access in children: a new learning approach in a rabbit model]

[https://www.chop.edu/clinical-pathway/sedation-analgesia-picu-mechanically-ventilated-patient-clinical-pathway PICU Clinical Pathway for Sedation/Analgesia in the Invasively Mechanically Ventilated Patient]

Society for Critical Care Medicine. ICU liberation. Accessed 07/14/2023, https://www.sccm.org/iculiberation

Fan E, Zakhary B, Amaral A, et al. Liberation from Mechanical Ventilation in Critically Ill Adults. An Official ATS/ACCP Clinical Practice Guideline. Ann Am Thorac Soc. Mar 2017;14(3):441-443. doi:10.1513/AnnalsATS.201612-993CME

Abu-Sultaneh S, Iyer NP, Fernández A, et al. Operational Definitions Related to Pediatric Ventilator Liberation. Chest. May 2023;163(5):1130-1143. doi:10.1016/j.chest.2022.12.010

Abu-Sultaneh S, Iyer NP, Fernández A, et al. Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Document. Am J Respir Crit Care Med. Jan 1 2023;207(1):17-28. doi:10.1164/rccm.202204-0795SO

Curley MA, Wypij D, Watson RS, et al. Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial. Jama. Jan 27 2015;313(4):379-89. doi:10.1001/jama.2014.18399

Blackwood B, Tume LN, Morris KP, et al. Effect of a Sedation and Ventilator Liberation Protocol vs Usual Care on Duration of Invasive Mechanical Ventilation in Pediatric Intensive Care Units: A Randomized Clinical Trial. Jama. Aug 3 2021;326(5):401-410. doi:10.1001/jama.2021.10296

Lavizzari, A, Zannin, E, Klotz, D, Dassios, T, Roehr, CC. State of the art on neonatal noninvasive respiratory support: how physiological and technological principles explain the clinical outcomes. Pediatr Pulmonol. 2023; 58: 2442-2455. doi:10.1002/ppul.26561

King BC, Gandhi BB, Jackson A, Katakam L, Pammi M, Suresh G. Mask versus Prongs for Nasal Continuous Positive Airway Pressure in Preterm Infants: A Systematic Review and Meta-Analysis. Neonatology. 2019;116(2):100-114. doi:10.1159/000496462

Yoder BA, Manley B, Collins C, Ives K, Kugelman A, Lavizzari A, McQueen M. Consensus approach to nasal high-flow therapy in neonates. Journal of Perinatology. 2017/07/01 2017;37(7):809-813. doi:10.1038/jp.2017.24

Iranpour R, Armanian AM, Abedi AR, Farajzadegan Z. Nasal high-frequency oscillatory ventilation (nHFOV) versus nasal continuous positive airway pressure (NCPAP) as an initial therapy for respiratory distress syndrome (RDS) in preterm and near-term infants. BMJ Paediatr Open. 2019;3(1):e000443. doi:10.1136/bmjpo-2019-000443

Gálvez JA, Acquah S, Ahumada L, et al. Hypoxemia, Bradycardia, and Multiple Laryngoscopy Attempts during Anesthetic Induction in Infants: A Single-center, Retrospective Study. Anesthesiology. Oct 2019;131(4):830-839. doi:10.1097/aln.0000000000002847

Fiadjoe J, Nishisaki A. Normal and difficult airways in children: "What's New"-Current evidence. Paediatric anaesthesia. Dec 23 2019;doi:10.1111/pan.13798

Fiadjoe JE, Litman RS. Oxygen supplementation during prolonged tracheal intubation should be the standard of care. British journal of anaesthesia. Oct 2016;117(4):417-418. doi:10.1093/bja/aew303

Polin RA, Carlo WA. Surfactant replacement therapy for preterm and term neonates with respiratory distress. Pediatrics. Jan 2014;133(1):156-63. doi:10.1542/peds.2013-3443

Sweet DG, Carnielli VP, Greisen G, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update. Neonatology. 2023;120(1):3-23. doi:10.1159/000528914

Ekhaguere OA, Mairami AB, Kirpalani H. Risk and benefits of Bubble Continuous Positive Airway Pressure for neonatal and childhood respiratory diseases in Low- and Middle-Income countries. Paediatr Respir Rev. Feb 2019;29:31-36. doi:10.1016/j.prrv.2018.04.004

[https://pubmed.ncbi.nlm.nih.gov/38097106/ Exerted force on the face mask in preterm infants at birth is associated with apnoea and bradycardia]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2024/10000/end_tidal_control_versus_manual_control_of.17.aspx End-Tidal Control Versus Manual Control of Inhalational Anesthesia Delivery: A Randomized Controlled Noninferiority Trial]

[https://www.bjaed.org/article/S2058-5349(24)00122-7/fulltext Causes and management of impaired gas exchange in critically ill patients]

[https://link.springer.com/content/pdf/10.1007/s44253-024-00047-0.pdf Flow trigger setting in mechanically ventilated neonates, children and adults: a scoping review]

Meyers M, Rodrigues N, Ari A. High-frequency oscillatory ventilation: a narrative review. Can J Respir Ther. 2019 May; 55: 40-46. PMID: 31297448

Wong R, Deakers T, Hotz J, Khemani RG, Ross PA, Newth CJ. Volume and pressure delivery during pediatric high-frequency oscillatory ventilation. Pediatr Crit Care Med. 2017 Apr; 18(4): e189-e194. PMID: 28212162

[https://www.bjanaesthesia.org/article/S0007-0912(25)00558-6/fulltext Efficacy of a lung recruitment manoeuvre in children undergoing general anaesthesia with a supraglottic airway]

Junod AF. Oxygen free radicals and lungs. Intensive Care Med. 1989;15 Suppl 1:S21-23. PMID: 2723243.

2. McIlroy DR, Shotwell MS, Lopez MG, Vaughn MT, Olsen JS, Hennessy C, Wanderer JP, Semler MS, Rice TW, Kheterpal S, Billings FT 4th; Multicenter Perioperative Outcomes Group. Oxygen administration during surgery and postoperative organ injury: observational cohort study. BMJ. 2022 Nov 30;379:e070941. PMID: 36450405

3. Balcarcel DR, Coates BM, Chong G, Sanchez-Pinto LN. Excessive Oxygen Supplementation in the First Day of Mechanical Ventilation Is Associated With Multiple Organ Dysfunction and Death in Critically Ill Children. Pediatr Crit Care Med. 2022 Feb 1;23(2):89-98. PMID: 35119429

4. Billings FT 4th, McIlroy DR, Shotwell MS, Lopez MG, Vaughn MT, Morse JL, Hennessey CJ, Wanderer JP, Semler MW, Rice TW, Wunsch H, Kheterpal S. Determinants and Practice Variability of Oxygen Administration during Surgery in the United States: A Retrospective Cohort Study. Anesthesiology. 2024 Sep 1;141(3):511-523. PMID: 38759157

5. Tian YQ, Wei W, Liu YQ, Xiao YY, Liu KJ, Li JH, Peng XM. Lung Ultrasound Evaluation of the Impact of Inspired Oxygen Fraction on Atelectasis During Induction of General Anesthesia in Pediatric Patients: A Randomized Controlled Trial. Shock. 2025 Dec 30. PMID: 41697232.

6. Wang Q, Li Y, Zhao K, Zhang J, Zhou J. Optimizing perioperative lung protection strategies for reducing postoperative respiratory complications in pediatric patients: a narrative review. Transl Pediatr. 2024 Nov 30;13(11):2043-2058. PMID: 39649647.

7. Zhang C, Xu F, Li W, Tong X, Xia R, Wang W, Du J, Shi X. Driving Pressure-Guided Individualized Positive End-Expiratory Pressure in Abdominal Surgery: A Randomized Controlled Trial. Anesth Analg. 2021 Nov 1;133(5):1197-1205. PMID: 34125080.

8. Balmaks E, Kentish SE, Seglenieks R, Lee JH, McGain F. Financial and environmental impacts of using oxygen rather than air as a ventilator drive gas. Anaesthesia. 2022 Dec;77(12):1451-1452. PMID: 36039020.

Advanced Airway Techniques

2026-05-07T15:04:33Z

WikiSysop:

{{Stub Notice}}

== Guidelines/General Approaches ==
[https://pubmed.ncbi.nlm.nih.gov/34762729/ 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway]

[https://www.ncbi.nlm.nih.gov/pubmed/30861424 The pediatric airway: Historical concepts, new findings, and what matters.]

[https://bjanaesthesia.org/article/S0007-0912(21)00176-8/fulltext BJA: Difficult airway management: children are different from adults, and neonates are different from children!]

[https://onlinelibrary.wiley.com/toc/14609592/2020/30/3 Pediatric Anesthesia: Special Issue:Pediatric Airway Special Issue]

[https://www.anesthesiologynews.com/download/Congenital_ANSE0720_WM.pdf The Congenital Difficult Airway in Pediatrics]

[https://www.nejm.org/doi/full/10.1056/NEJMra1916801/ NEJM: Management of the Difficult Airway]

[https://www.karger.com/Article/Fulltext/481979 The Laryngeal Mask Airway and Its Use in Neonatal Resuscitation: A Critical Review of Where We Are in 2017/2018]

== Emergency Response ==
[https://apps.apple.com/us/app/pedi-crisis-2-0/id1409734476 Pedi Crisis 2.0 - application]

== Videolaryngoscopy ==
[https://pubmed.ncbi.nlm.nih.gov/42080668/ Airway Management in Neonates and Young Infants: Changes in Clinical Outcomes With Adoption of Routine Video Laryngoscopy in a Single Center Retrospective Cohort]

[https://link.springer.com/article/10.1007/s12630-021-02162-4 Video laryngoscopy 2.0]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00065-5/abstract Comparison of tracheal intubation conditions between the operating room and intensive care unit: impact of universal videolaryngoscopy]

[https://www.nejm.org/doi/full/10.1056/NEJMoa2402785 Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infants]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16394 Prospective development and validation of a universal classification for paediatric videolaryngoscopic tracheal intubation: the PeDiAC score]

[https://pubmed.ncbi.nlm.nih.gov/39907265/ Availability and Practice Patterns of Videolaryngoscopy and Adaptation of Apneic Oxygenation in Pediatric Anesthesia: A Cross-Sectional Survey of Pediatric Anesthesiologists]

[https://journals.lww.com/ejanaesthesiology/fulltext/2026/03000/universal_videolaryngoscopy__between_current.16.aspx Universal videolaryngoscopy: between current evidence and ethical imperatives]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16704 Assessing the incidence of `can see, cannot intubate easily´during routine use of C-MAC videolaryngoscopy]

== Fiberoptic Laryngoscopy ==
[https://www.youtube.com/watch?v=oO2aSOYMKDg Fiberoptic Intubation Air-Q SGA with Continuous Ventilation by Jim DuCanto]

[https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000004431/137372/Difficult-Airway-Management-in-Neonates-Fiberoptic Difficult Airway Management in Neonates: Fiberoptic Intubation via Laryngeal Mask Airway]

[https://pubmed.ncbi.nlm.nih.gov/11915066/ Airway regional anesthesia for awake fiberoptic intubation]

== Light Wand ==
[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.1979.tb06379.x ‘Light wand’ intubation]

[https://pubmed.ncbi.nlm.nih.gov/28470901/ A simple homemade lighted stylet for neonates and infants: a description and case report of its use in an infant with the Pierre Robin anomalad]

== Bougie/Stylet ==
[https://pubmed.ncbi.nlm.nih.gov/18211445/ Intubation of infants with Pierre Robin syndrome: the use of the paraglossal approach combined with a gum-elastic bougie in six consecutive cases]

[https://pubmed.ncbi.nlm.nih.gov/15505469/ The Eschmann Tracheal Tube Introducer Is Not Gum, Elastic, or a Bougie]

== Cricothyrotomy/FONA ==
[https://pubmed.ncbi.nlm.nih.gov/22313556/ Emergency surgical cricothyroidotomy: 24 successful cases leading to a simple 'scalpel-finger-tube' method]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14796 Emergency front-of-neck access in infants: A pragmatic crossover randomized control trial comparing two approaches on a simulated rabbit model]

[https://pubmed.ncbi.nlm.nih.gov/39381516 An exploration of the cognitive and affective processes for anaesthetists when performing an emergency front of neck airway]

[https://onlinelibrary.wiley.com/doi/full/10.1111/pan.14875 Emergency front-of-neck access in pediatric anesthesia: A narrative review]

The trachea heals but the hypoxia does not' an emergency front-of-neck access in a 4-year-old with foreign body airway obstruction. European journal of anaesthesiology 2025, 42(10):945–947.

Emergency front-of-neck access: Lessons from a real-world CICO case. European journal of anaesthesiology 2025, 42(10):863–865.

Emergency front of neck access in airway management. BJA Educ 2019, 19(8):246–253.

Haag AK, Tredese A, Bordini M, et al. Emergency front-of-neck access in pediatric anesthesia: A narrative review. Paediatr Anaesth 2024;34(6):495–506. (In eng). DOI: 10.1111/pan.14875.

Morais D, Cordeiro A, Rego S. Frova Introducer in Anesthesiology: Friend or Foe? Cureus 2025;17(8):e90723. DOI: 10.7759/cureus.90723.

Eckmann DM, Seligman I, Coté CJ, Hussong JW. Mucormycosis supraglottitis on induction of anesthesia in an immunocompromised host. Anesth Analg 1998;86(4):729–30. (In eng). DOI: 10.1097/00000539-199804000-00010.

Coté CJ, Eavey RD, Todres ID, Jones DE. Crocothyroid membrane puncture: oxygenation and ventilation in a dog model using an intravenous catheter. Crit Care Med 1988;16:615–619.

Lyons C, Callaghan M. Uses and mechanisms of apnoeic oxygenation: a narrative review. Anaesthesia 2019;74(4):497–507. DOI: https://doi.org/10.1111/anae.14565.

Slutsky AS, Brown R. Cardiogenic oscillations: a potential mechanism enhancing oxygenation during apneic respiration. Med Hypotheses 1982;8(4):393–400. (In eng). DOI: 10.1016/0306-9877(82)90032-9.

Goldstein B, Shannon DC, Todres ID. Supercarbia in children: clinical course and outcome. Crit Care Med 1990;18(2):166–8. DOI: 10.1097/00003246-199002000-00008.

Coté CJ, Hartnick CJ. Pediatric transtracheal and cricothyrotomy airway devices for emergency use: which are appropriate for infants and children? Paediatr Anaesth 2009;19 Suppl 1:66–76. DOI: 10.1111/j.1460-9592.2009.02996.x.

[https://www.sciencedirect.com/science/article/pii/S2772609625001509 A protocol for an emergency front-of-neck airway registry in the United Kingdom]

[https://journals.lww.com/anesthesiology/citation/2026/04000/rediscovering_retrograde_intubation__a_classic_but.29.aspx Rediscovering Retrograde Intubation: A Classic but Indispensable Technique in the Era of Video Laryngoscopy]

== Complications ==
[https://pubs.asahq.org/anesthesiology/article/135/3/495/116017/Dramatic-Cervical-Spine-Injury-Secondary-to Dramatic Cervical Spine Injury Secondary to Videolaryngoscopy in a Patient Suffering from Ankylosing Spondylitis]

== Non-OR Airway Management ==
[https://picudoconcall.org/?captivate_podcast=11 Management of High Risk Intubations in the PICU | picudoconcall.org]

[https://pubmed.ncbi.nlm.nih.gov/36841658/ The Pediatric Bougie for the First Tracheal Intubation Attempt in Critically Ill Children]

== Communication ==
[https://onlinelibrary.wiley.com/doi/10.1111/pan.14760 The role of WhatsApp™ in pediatric difficult airway management: A study from the PeDI Collaborative]

== Specific Situations ==
[https://bjaed.org/article/S2058-5349(20)30032-9/pdf Paediatric adenotonsillectomy (considerations for anaesthesia), part 1]
[https://bjaed.org/article/S2058-5349(20)30033-0/pdf part 2]

[https://www.anesthesiologynews.com/Review-Articles/Article/08-19/10-Common-Pediatric-Airway-Problems-And-Their-Solutions/55657?sub=D0CBDA824FBCB7AA4A61CCDE9984A8F4D0A8A95B29CEB0A1653EDA6256BD25&enl=true&dgid=&utm_source=enl&utm_content=2&utm_campaign=20200801&utm_medium=button AnesNews: 10 Common Pediatric Airway Problems—And Their Solutions]

[https://bjanaesthesia.org/article/S0007-0912(21)00116-1/fulltext Difficult tracheal intubation in neonates and infants. (NECTARINE)]

[https://pubmed.ncbi.nlm.nih.gov/21789701/ A new modification for safer submental orotracheal intubation]

[http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-33472020000200091 Submental intubation in pediatric maxillofacial surgery: report of 2 cases]

[https://pubmed.ncbi.nlm.nih.gov/26919822/ Lignocaine topicalization of the pediatric airway]

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10720842/ Airway management in neonates and infants]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16290 Airway management in patients with suspected or confirmed cervical spine injury]

[https://journals.lww.com/anesthesia-analgesia/abstract/2025/02000/awake_supraglottic_airway_placement_in_pediatric.13.aspx Awake Supraglottic Airway Placement in Pediatric Patients for Airway Obstruction or Difficult Intubation: Insights From an International Airway Registry (PeDI)]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.14322 A modified adjustable oral RAE microcuff® endotracheal tube]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2044.1991.tb09315.x?sid=nlm%3Apubmed Accidental bronchial intubation with RAE tubes]

Apneic Oxygenation

[https://pubmed.ncbi.nlm.nih.gov/38030551/ Apnoeic oxygenation during paediatric tracheal intubation: a systematic review and meta-analysis]

[https://pubmed.ncbi.nlm.nih.gov/38065762/ Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines]

[https://pubmed.ncbi.nlm.nih.gov/34762729/ 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway]

[https://pubmed.ncbi.nlm.nih.gov/29699900/ Apneic oxygenation reduces hypoxemia during endotracheal intubation in the pediatric emergency department]

[https://pubmed.ncbi.nlm.nih.gov/36650568/ Effect of apneic oxygenation with intubation to reduce severe desaturation and adverse tracheal intubation-associated events in critically ill children]

[https://pubmed.ncbi.nlm.nih.gov/24838096/ Safe oxygen saturation targeting and monitoring in preterm infants: can we avoid hypoxia and hyperoxia? Acta]

Rehman MA, Schreiner MS. Oral and nasotracheal light wand guided intubation after failed fibreoptic bronchoscopy. Paediatric anaesthesia 1997;7(4):349-51. (In eng). DOI: 10.1046/j.1460-9592.1997.d01-85.x.

[https://pubmed.ncbi.nlm.nih.gov/8467551/ Difficult laryngoscopy made easy with a "BURP"]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16366 Universal paediatric videolaryngoscopy and glottic view grading: a prospective observational study]

[https://www.bjaed.org/article/S2058-5349(24)00092-1/abstract Teaching and training advanced airway management]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00505-1/abstract Optimal McGRATH® MAC videolaryngoscope blade size for small children]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16366 Universal paediatric videolaryngoscopy and glottic view grading: a prospective observational study]

[https://resources.wfsahq.org/atotw/use-of-supraglottic-airways-sgas-as-rescue-devices-conduits-for-tracheal-intubation-ti-and-other-special-cases/ WFSA Tutorial: Use of Supraglottic Airways (SGAs) as Rescue Devices, Conduits for Tracheal Intubation (TI), and Other Special Cases]

[https://www.sciencedirect.com/science/article/pii/S000709122500279X Incidence of cognitive errors in difficult airway management: an inference human factors study from the Pediatric Difficult Intubation Registry]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16705 Consensus recommendations for paediatric airway topicalisation using lidocaine]

[https://www.bjanaesthesia.org/article/S0007-0912(25)00279-X/fulltext Incidence of cognitive errors in difficult airway management: an inference human factors study from the Pediatric Difficult Intubation Registry]

[https://www.bjanaesthesia.org/article/S0007-0912(25)00340-X/fulltext Cognitive errors in paediatric difficult airway management: a step into the unknown]

[https://www.bjaopen.org/article/S2772-6096(25)00040-1/fulltext Ethical decision making in airway management: a Difficult Airway Society position statement on good practice]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16731 Implementation of default videolaryngoscopy instead of direct laryngoscopy for tracheal intubation: a narrative review of evidence and experiences]

Bai W., P. Koppera, Y. Yuan, G. Mentz, B.Pearce, M. Therrian, P. Reynolds, S. E. S. Brown. Availability and Practice Patterns of Videolaryngoscopy and Adaptation of Apneic Oxygenation in Pediatric Anesthesia: A Cross-Sectional Survey of Pediatric Anesthesiologists. Paediatr Anaesth. 2025A; 35(6):460–468. DOI: 10.1111/pan.15079. Epub 2025 Feb 5.PMID: 39907265; PMCID: PMC12060081.

[https://journals.lww.com/anesthesiology/abstract/9900/high_flow_nasal_oxygenation_in_infants_undergoing.883.aspx High-Flow Nasal Oxygenation in Infants Undergoing Tracheal Intubation: A Single-center Randomized Controlled Trial]

[https://pubmed.ncbi.nlm.nih.gov/28393433/ Nasal high-flow oxygen delivery in children with abnormal airways]

Psychological Preparation of the Pediatric Patient & Family

2026-05-05T16:32:55Z

WikiSysop:

Succinylcholine

2026-05-05T12:19:12Z

WikiSysop:

{{Stub Notice}}

[https://onlinelibrary.wiley.com/doi/10.1111/j.1460-9592.2009.03032.x The place of suxamethonium in pediatric anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/2097911/ Submental administration of succinylcholine in children]

[https://journals.lww.com/anesthesia-analgesia/citation/1968/09000/intralingual_succinylcholine_administration_in.31.aspx Intralingual Succinylcholine Administration in Children An Alternative to Intravenous and Intramuscular Routes?]

[https://pubmed.ncbi.nlm.nih.gov/20624143/ Evaluating degradation with fragment formation of prehospital succinylcholine by mass spectrometry]

[https://pubmed.ncbi.nlm.nih.gov/23711878/ Impact of temperature exposure on stability of drugs in a real-world out-of-hospital setting]

[https://pubmed.ncbi.nlm.nih.gov/35717271/ Impact of Ambient Temperature on 5 Emergency Drugs Aboard an Emergency Medical Car Over a 1-Year Period]

[https://pubmed.ncbi.nlm.nih.gov/17351219/ Stability of succinylcholine solutions stored at room temperature studied by nuclear magnetic resonance spectroscopy]

[https://pubmed.ncbi.nlm.nih.gov/28079581/ Assessing the Impact of the Anesthesia Medication Template on Medication Errors During Anesthesia: A Prospective Study]

[https://pubmed.ncbi.nlm.nih.gov/2372857/ A defasciculating dose of d-tubocurarine causes resistance to succinylcholine]

[https://journals.lww.com/anesthesia-analgesia/citation/2025/12000/the_myth_of_the_phase_i_block_after.13.aspx The Myth of the Phase I Block After Succinylcholine in Clinical Practice]

Carl J, Schwarzer M, Klingelhoefer D, Ohlendorf D, Groneberg DA. Curare--a curative poison: a scientometric analysis. PLoS One. 2014 Nov 19;9(11):e112026. doi: 10.1371/journal.pone.0112026.

https://www.woodlibrarymuseum.org/museum/succinylcholine/ (accessed 12/25/2025)

Lee, C. (2009), Goodbye Suxamethonium! Anaesthesia, 64: 73-81. https://doi.org/10.1111/j.1365-2044.2008.05873.x

Delphin, E, Jackson, D, Rothstein, P. Use of Succinylcholine During Elective Pediatric Anesthesia Should Be Reevaluated. Anesth Analg. 1987;66(11):1190-1192. Cited in: Journals@Ovid Full Text at https://ovidsp.ovid.com/ovidweb.cgi?T=J ... 1000-00022. Accessed January 02, 2026.

Rosenberg, H, Gronert, G. Intractable Cardiac Arrest in Children Given Succinylcholine. Anesthesiology. 1992;77(5):1054. Cited in: Journals@Ovid Full Text at https://ovidsp.ovid.com/ovidweb.cgi?T=J ... 1000-00040. Accessed January 02, 2026.

Gronert, G, Theye, R. Pathophysiology of Hyperkalemia Induced by Succinylcholine. Anesthesiology. 1975; 43(1): 89-98. Cited in: Journals@Ovid Full Text at https://ovidsp.ovid.com/ovidweb.cgi?T=J ... 7000-00018. Accessed January 05, 2026.

Larach MG, Rosenberg H, Gronert GA, Allen GC. Hyperkalemic cardiac arrest during anesthesia in infants and children with occult myopathies. Clin Pediatr (Phila). 1997 Jan; 36(1): 9-16. doi: 10.1177/000992289703600102. PMID: 9007342.

Succinylcholine Chloride-Full Prescribing Information https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=1d4302db-a0d5-d0e8-e063-6294a90a22f8 (accessed 12/25/2025)

McAuliffe, G., Bissonnette, B. & Boutin, C. Should the routine use of atropine before succinylcholine in children be reconsidered? Can J Anaesth 42, 724–729 (1995). https://doi-org.proxy.library.upenn.edu/10.1007/BF03012672

Fleming B, McCollough M, Henderson HO. Myth: Atropine should be administered before succinylcholine for neonatal and pediatric intubation. CJEM. 2005 Mar;7(2):114-7. doi: 10.1017/s1481803500013075. PMID: 17355661.

[https://pubmed.ncbi.nlm.nih.gov/1147311/ Pathophysiology of Hyperkalemia Induced by Succinylcholine]

Succinylcholine

2026-05-05T11:37:40Z

WikiSysop:

Compartment Syndrome and Regional Blockade

2026-05-04T23:55:40Z

WikiSysop:

{{Stub Notice}}

[https://journals.lww.com/anesthesia-analgesia/fulltext/2021/11000/regional_anesthesia_and_compartment_syndrome.35.aspx Regional Anesthesia and Compartment Syndrome]

[https://pubmed.ncbi.nlm.nih.gov/20881529/ Acute compartment syndrome and the role of regional anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/24049839/ Does regional anaesthesia in trauma patients lead to delayed recognition of compartment syndrome?]

[https://pubmed.ncbi.nlm.nih.gov/35410917/ Concerns regarding "Regional anesthesia and acute compartment syndrome: principles for practice"]

[https://pubmed.ncbi.nlm.nih.gov/36049877/ Acute Extremity Compartment Syndrome and (Regional): Anesthesia: The Monster Under the Bed]

[https://pubmed.ncbi.nlm.nih.gov/36447735/ Coping With the Fear of Compartment Syndrome Without Compromising Analgesia: A Narrative Review]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2023/05000/pro_con_debate__peripheral_nerve_blockade_should.7.aspx Pro-Con Debate: Peripheral Nerve Blockade Should Be Provided Routinely in Extremity Trauma, Including in Patients At Risk for Acute Compartment Syndrome]

[https://pubmed.ncbi.nlm.nih.gov/34187911/ Regional anesthesia and acute compartment syndrome: principles for practice]

[http://dx.doi.org/10.1097/OI9.0000000000000163 Animal models in compartment syndrome: a review of existing literature]

[https://www.anesthesiologynews.com/Clinical-Anesthesiology/Article/10-25/Study-Finds-Nerve-Blocks-Dont-Delay-Compartment-Syndrome-Diagnosis-in-Children/78381 Study Finds Nerve Blocks Don’t Delay Compartment Syndrome Diagnosis in Children]

[https://journals.lww.com/anesthesiology/abstract/9900/ropivacaine_based_regional_anesthesia_exerts.884.aspx Ropivacaine-Based Regional Anesthesia Exerts Muscle-Protective Effects Despite Elevated Compartment Pressure In A Porcine Model Of Acute Compartment Syndrome]

[https://journals.lww.com/anesthesiology/fulltext/2026/05000/ropivacaine_based_regional_anesthesia_exerts.26.aspx Ropivacaine-based Regional Anesthesia Exerts Muscle-protective Effects Despite Elevated Compartment Pressure in a Porcine Model of Acute Compartment Syndrome]

General Preoperative Assessment

2026-05-01T19:00:11Z

WikiSysop:

=Introduction=
The preoperative assessment is the first step in providing effective anesthesia for a patient. It is a process by which the anesthesia provider intentionally evaluates their patient and creates a plan to safely conduct anesthetic care. As many surgeries are becoming outpatient cases, the preoperative assessment is often done on the day of surgery, however, depending on the patient and their comorbidities, the nature of the surgery, and the institution providing care, this assessment can also be done further in advance in a preoperative clinic setting. The major goals of the preoperative assessment are to build rapport with the patient and their support person(s), ensure the patient is medically fit for surgery, perform a physical exam including airway exam, educate on the risks and benefits of the anesthetic plan, determine the need for any special monitors, lab work or medications, and obtain informed consent.

=Chart Review=

==History and Physical==
Obtaining a focused yet thorough patient history is a hallmark of the preoperative assessment. History often includes:

# Medical history and comorbidities (include gestational age, complications at birth/NICU admission)
# Family history of complications with anesthetics (i.e. malignant hyperthermia, pseudocholinesterase deficiency)
# Indications for the surgery
# NPO status
# History of previous anesthetics and any known complications (i.e. difficult airway, PONV, intraoperative complications)
# History of current/recent upper respiratory tract infections
# Any known allergies
# Medications
# Review of systems

Medical History - obvious reasons

Family History - important to ask as many first anesthetic for most

Indication for surgery - positioning

NPO status - insert NPO time table. important for decreasing aspiration risk

Prev anes- guide your current plan

URI - case cancellation, laryngospasm risk

Allergies- to medications, foods, environmental factors.

Meds - drug interactions

ROS - insert another table

==Pre-operative Labs==

#Hemoglobin/hematocrit/platelets
#Electrolytes
#Liver function
#Coagulation
#Specifically indicated

==Pre-operative Imaging==

#Chest x-ray
#CT scan
#MRI

=ASA Physical Status Classification=

[https://journals.lww.com/anesthesiologyopen/fulltext/2026/04000/american_society_of_anesthesiologists_statement_on.2.aspx Statement on ASA Physical Status Classification System]

=Discussion with Surgeon/Procedurist=

Discussion with patient/parent [guardiab]

{{Stub Notice}}

[https://viaaerearcp.files.wordpress.com/2020/02/evaluacion-preanestesica2018.pdf Preoperative anesthesia evaluation]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.12052 Paediatric emergencies]

[https://pubmed.ncbi.nlm.nih.gov/31219919/ One Size Does Not Fit All: A Perspective on the American Society of Anesthesiologists Physical Status Classification for Pediatric Patients]

[https://pubmed.ncbi.nlm.nih.gov/32665468/ The Pediatric-Specific American Society of Anesthesiologists Physical Status Score: A Multicenter Study]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16723 Age, ASA physical status and surgical outcomes: insights from a nationwide cohort study]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/assessment_of_gastric_content_using_gastric.1493.aspx Assessment of Gastric Content Using Gastric Ultrasound in Patients on Glucagon-Like Peptide-1 Receptor Agonists Before Anesthesia]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.70046 ASA physical status classification: a relic of a bygone time?]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2026/01000/enhancing_anesthetic_preoptimization__promising.14.aspx Enhancing Anesthetic Preoptimization: Promising Opportunities for Innovation in Economically Diverse Regions]

[https://journals.lww.com/anesthesiologyopen/fulltext/2026/01000/american_society_of_anesthesiologists_statement_on.2.aspx American Society of Anesthesiologists Statement on ASA Physical Status Classification System]

[https://pubmed.ncbi.nlm.nih.gov/41698393/ The Pediatrician's Role in the Evaluation and Preparation of Pediatric Patients Undergoing Anesthesia]

1. Beckman HB, Frankel RM: The effect of physician behavior on the collection of data. Annals of internal medicine 1984, 101(5):692–696.

2. Roter D, Larson S: The Roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions. Patient Educ Couns 2002, 46(4):243–251.

3. Lichstein PR: The medical interview. Clinical Methods: The History, Physical, and Laboratory Examinations 3rd edition 1990.

4. Marvel MK, Epstein RM, Flowers K, Beckman HB: Soliciting the patient’s agenda: have we improved? Jama 1999, 281(3):283–287.

5. Dyche L, Swiderski D: The effect of physician solicitation approaches on ability to identify patient concerns. Journal of general internal medicine 2005, 20(3):267–270.

6. Willging AM, Castro E, Xu J: Physician-patient communication in vascular surgery: Analysis of encounters in academic practice. SAGE Open Med 2022, 10:20503121221122414.

General Preoperative Assessment

2026-05-01T18:59:35Z

WikiSysop:

=Introduction=
The preoperative assessment is the first step in providing effective anesthesia for a patient. It is a process by which the anesthesia provider intentionally evaluates their patient and creates a plan to safely conduct anesthetic care. As many surgeries are becoming outpatient cases, the preoperative assessment is often done on the day of surgery, however, depending on the patient and their comorbidities, the nature of the surgery, and the institution providing care, this assessment can also be done further in advance in a preoperative clinic setting. The major goals of the preoperative assessment are to build rapport with the patient and their support person(s), ensure the patient is medically fit for surgery, perform a physical exam including airway exam, educate on the risks and benefits of the anesthetic plan, determine the need for any special monitors, lab work or medications, and obtain informed consent.

=Chart Review=

==History and Physical==
Obtaining a focused yet thorough patient history is a hallmark of the preoperative assessment. History often includes:

# Medical history and comorbidities (include gestational age, complications at birth/NICU admission)
# Family history of complications with anesthetics (i.e. malignant hyperthermia, pseudocholinesterase deficiency)
# Indications for the surgery
# NPO status
# History of previous anesthetics and any known complications (i.e. difficult airway, PONV, intraoperative complications)
# History of current/recent upper respiratory tract infections
# Any known allergies
# Medications
# Review of systems

Medical History - obvious reasons

Family History - important to ask as many first anesthetic for most

Indication for surgery - positioning

NPO status - insert NPO time table. important for decreasing aspiration risk

Prev anes- guide your current plan

URI - case cancellation, laryngospasm risk

Allergies- to medications, foods, environmental factors.

Meds - drug interactions

ROS - insert another table

==Pre-operative Labs==

#Hemoglobin/hematocrit/platelets
#Electrolytes
#Liver function
#Coagulation
#Specifically indicated

==Pre-operative Imaging==

#Chest x-ray
#CT scan
#MRI

=ASA Physical Status Classification=

[https://journals.lww.com/anesthesiologyopen/fulltext/2026/04000/american_society_of_anesthesiologists_statement_on.2.aspx Statement on ASA Physical Status Classification System]

[https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system Statement on ASA Physical Status Classification System]

=Discussion with Surgeon/Procedurist=

Discussion with patient/parent [guardiab]

{{Stub Notice}}

[https://viaaerearcp.files.wordpress.com/2020/02/evaluacion-preanestesica2018.pdf Preoperative anesthesia evaluation]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.12052 Paediatric emergencies]

[https://pubmed.ncbi.nlm.nih.gov/31219919/ One Size Does Not Fit All: A Perspective on the American Society of Anesthesiologists Physical Status Classification for Pediatric Patients]

[https://pubmed.ncbi.nlm.nih.gov/32665468/ The Pediatric-Specific American Society of Anesthesiologists Physical Status Score: A Multicenter Study]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16723 Age, ASA physical status and surgical outcomes: insights from a nationwide cohort study]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/assessment_of_gastric_content_using_gastric.1493.aspx Assessment of Gastric Content Using Gastric Ultrasound in Patients on Glucagon-Like Peptide-1 Receptor Agonists Before Anesthesia]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.70046 ASA physical status classification: a relic of a bygone time?]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2026/01000/enhancing_anesthetic_preoptimization__promising.14.aspx Enhancing Anesthetic Preoptimization: Promising Opportunities for Innovation in Economically Diverse Regions]

[https://journals.lww.com/anesthesiologyopen/fulltext/2026/01000/american_society_of_anesthesiologists_statement_on.2.aspx American Society of Anesthesiologists Statement on ASA Physical Status Classification System]

[https://pubmed.ncbi.nlm.nih.gov/41698393/ The Pediatrician's Role in the Evaluation and Preparation of Pediatric Patients Undergoing Anesthesia]

1. Beckman HB, Frankel RM: The effect of physician behavior on the collection of data. Annals of internal medicine 1984, 101(5):692–696.

2. Roter D, Larson S: The Roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions. Patient Educ Couns 2002, 46(4):243–251.

3. Lichstein PR: The medical interview. Clinical Methods: The History, Physical, and Laboratory Examinations 3rd edition 1990.

4. Marvel MK, Epstein RM, Flowers K, Beckman HB: Soliciting the patient’s agenda: have we improved? Jama 1999, 281(3):283–287.

5. Dyche L, Swiderski D: The effect of physician solicitation approaches on ability to identify patient concerns. Journal of general internal medicine 2005, 20(3):267–270.

6. Willging AM, Castro E, Xu J: Physician-patient communication in vascular surgery: Analysis of encounters in academic practice. SAGE Open Med 2022, 10:20503121221122414.

General Preoperative Assessment

2026-05-01T18:58:29Z

WikiSysop:

=Introduction=
The preoperative assessment is the first step in providing effective anesthesia for a patient. It is a process by which the anesthesia provider intentionally evaluates their patient and creates a plan to safely conduct anesthetic care. As many surgeries are becoming outpatient cases, the preoperative assessment is often done on the day of surgery, however, depending on the patient and their comorbidities, the nature of the surgery, and the institution providing care, this assessment can also be done further in advance in a preoperative clinic setting. The major goals of the preoperative assessment are to build rapport with the patient and their support person(s), ensure the patient is medically fit for surgery, perform a physical exam including airway exam, educate on the risks and benefits of the anesthetic plan, determine the need for any special monitors, lab work or medications, and obtain informed consent.

=Chart Review=

==History and Physical==
Obtaining a focused yet thorough patient history is a hallmark of the preoperative assessment. History often includes:

# Medical history and comorbidities (include gestational age, complications at birth/NICU admission)
# Family history of complications with anesthetics (i.e. malignant hyperthermia, pseudocholinesterase deficiency)
# Indications for the surgery
# NPO status
# History of previous anesthetics and any known complications (i.e. difficult airway, PONV, intraoperative complications)
# History of current/recent upper respiratory tract infections
# Any known allergies
# Medications
# Review of systems

Medical History - obvious reasons

Family History - important to ask as many first anesthetic for most

Indication for surgery - positioning

NPO status - insert NPO time table. important for decreasing aspiration risk

Prev anes- guide your current plan

URI - case cancellation, laryngospasm risk

Allergies- to medications, foods, environmental factors.

Meds - drug interactions

ROS - insert another table

==Pre-operative Labs==

#Hemoglobin/hematocrit/platelets
#Electrolytes
#Liver function
#Coagulation
#Specifically indicated

==Pre-operative Imaging==

#Chest x-ray
#CT scan
#MRI

=ASA Physical Status Classification=

[https://journals.lww.com/anesthesiologyopen/fulltext/2026/04000/american_society_of_anesthesiologists_statement_on.2.aspx Statement on ASA Physical Status Classification System]

=Discussion with Surgeon/Procedurist=

Discussion with patient/parent [guardiab]

{{Stub Notice}}

[https://viaaerearcp.files.wordpress.com/2020/02/evaluacion-preanestesica2018.pdf Preoperative anesthesia evaluation]

[https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system Statement on ASA Physical Status Classification System]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.12052 Paediatric emergencies]

[https://pubmed.ncbi.nlm.nih.gov/31219919/ One Size Does Not Fit All: A Perspective on the American Society of Anesthesiologists Physical Status Classification for Pediatric Patients]

[https://pubmed.ncbi.nlm.nih.gov/32665468/ The Pediatric-Specific American Society of Anesthesiologists Physical Status Score: A Multicenter Study]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16723 Age, ASA physical status and surgical outcomes: insights from a nationwide cohort study]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/assessment_of_gastric_content_using_gastric.1493.aspx Assessment of Gastric Content Using Gastric Ultrasound in Patients on Glucagon-Like Peptide-1 Receptor Agonists Before Anesthesia]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.70046 ASA physical status classification: a relic of a bygone time?]

[https://journals.lww.com/anesthesia-analgesia/fulltext/2026/01000/enhancing_anesthetic_preoptimization__promising.14.aspx Enhancing Anesthetic Preoptimization: Promising Opportunities for Innovation in Economically Diverse Regions]

[https://journals.lww.com/anesthesiologyopen/fulltext/2026/01000/american_society_of_anesthesiologists_statement_on.2.aspx American Society of Anesthesiologists Statement on ASA Physical Status Classification System]

[https://pubmed.ncbi.nlm.nih.gov/41698393/ The Pediatrician's Role in the Evaluation and Preparation of Pediatric Patients Undergoing Anesthesia]

1. Beckman HB, Frankel RM: The effect of physician behavior on the collection of data. Annals of internal medicine 1984, 101(5):692–696.

2. Roter D, Larson S: The Roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions. Patient Educ Couns 2002, 46(4):243–251.

3. Lichstein PR: The medical interview. Clinical Methods: The History, Physical, and Laboratory Examinations 3rd edition 1990.

4. Marvel MK, Epstein RM, Flowers K, Beckman HB: Soliciting the patient’s agenda: have we improved? Jama 1999, 281(3):283–287.

5. Dyche L, Swiderski D: The effect of physician solicitation approaches on ability to identify patient concerns. Journal of general internal medicine 2005, 20(3):267–270.

6. Willging AM, Castro E, Xu J: Physician-patient communication in vascular surgery: Analysis of encounters in academic practice. SAGE Open Med 2022, 10:20503121221122414.

Apert Syndrome

2026-04-30T12:35:04Z

WikiSysop:

{{Stub Notice}}

[https://www.sciencedirect.com/science/article/pii/S1110184914000877 Apert syndrome: Anaesthetic concerns and challenges]

[https://pubmed.ncbi.nlm.nih.gov/31145570/ Apert Syndrome]

[https://pubmed.ncbi.nlm.nih.gov/25191197/ Anesthetic management of craniosynostosis repair in patient with Apert syndrome]

[https://pubmed.ncbi.nlm.nih.gov/2065485/ Apert syndrome. Anesthetic management]

[https://pubmed.ncbi.nlm.nih.gov/31137453/ Apert Syndrome: Intraoperative and Postoperative Hyponatremia]

[https://pubmed.ncbi.nlm.nih.gov/21073626/ Perioperative complications in children with Apert syndrome: a review of 509 anesthetics]

Management of the Airway in Apert Syndrome. Xie C, De S, Selby A. The Journal of Craniofacial Surgery. 2016;27(1):137-41. doi:10.1097/SCS.0000000000002333.

Airway Analysis in Apert Syndrome. Forte AJ, LuX, Hashim PW, et al. Plastic and Reconstructive Surgery. Surgery. doi: doi:10.1097/PRS.0000000000005937.

Morphological Basis for Airway Surgical Intervention in Apert Syndrome. Lu X, Forte AJ, Park KE, et al. Annals of Plastic Surgery. 2021;87(1):59-64.
doi:10.1097/SAP.0000000000002601.

Genetic Subtypes of Apert Syndrome Are Associated With Differences in Airway Morphology and Early Upper Airway Obstruction. Wagner CS, Wietlisbach LE, Kota A, et
al. The Journal of Craniofacial Surgery. 2023;34(7):1999-2003. doi:10.1097/SCS.0000000000009583.

Atresia and Craniosynostosis: Development and Disease. Lesciotto KM, Heuzé Y, Jabs EW, Bernstein JM, Richtsmeier JT. Plastic and Reconstructive Surgery.
2018;141(1):156-168. doi: 10.1097/PRS.0000000000003928.

Perioperative Complications in Children With Apert Syndrome: A Review of 509 Anesthetics. Barnett S, Moloney C, Bingham R. Paediatric Anaesthesia. 2011;21(1):72-7.
doi:10.1111/j.1460-9592.2010.03457.x.

Airway Anomalies in Patients With Craniosynostosis. Mathews F, Shaffer AD, Georg MW, et al. The Laryngoscope. 2019;129(11):2594-2602. doi: 10.1002/lary.27589.

Pediatric Airway Management. John E. Fiadjoe, Paul A. Stricker, Ronald S. Litman. Chapter 16.

Airway Statuses and Nasopharyngeal Airway Use for Airway Obstruction in Syndromic Craniosynostosis. Kouga T, Tanoue K, Matsui K. The Journal of Craniofacial
Surgery. 2014;25(3):762-5. doi: 10.1097/SCS.0000000000000763.

Respiratory and Craniofacial Management in Children With Apert Syndrome. Khirani S, Paternoster G, Luscan R, et al. Journal of Cranio-Maxillo-Facial Surgery: Official
Publication of the European Association for Cranio-Maxillo-Facial Surgery. 2025;:S1010-5182(25)00115-5. doi: 10.1016/j.jcms.2025.03.019.

Mitochondrial Disease

2026-04-30T00:04:47Z

WikiSysop:

Mitochondrial Disease

2026-04-30T00:03:01Z

WikiSysop:

{{Stub Notice}}

See also: [[Leigh’s Syndrome]]

[https://pubmed.ncbi.nlm.nih.gov/27885500/ A review of anaesthetic outcomes in patients with genetically confirmed mitochondrial disorders]

[https://med.stanford.edu/content/dam/sm/pedsanesthesia/documents/mitochondrial-disease.pdf Mitochondrial Disease and Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/33591116/ Anesthetic Hypersensitivity in a Case-Controlled Series of Patients With Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/25503498/ Diagnosis and management of mitochondrial disease: a consensus statement from the Mitochondrial Medicine Society]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.12158 Anesthetic considerations in patients with mitochondrial defects]

[https://pubmed.ncbi.nlm.nih.gov/33752971/ Hypoxia ameliorates brain hyperoxia and NAD(+) deficiency in a murine model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/26917594/ Hypoxia as a therapy for mitochondrial disease]

[https://www.openanesthesia.org/vodcasts/anesthetic-considerations-in-patients-with-mitochondrial-disease/ Open Anesthesia: Anesthetic Considerations in Patients with Mitochondrial Disease]

[https://pubmed.ncbi.nlm.nih.gov/23923677/ Mitochondrial diseases and anesthesia: a literature review of current opinions]

[https://pubmed.ncbi.nlm.nih.gov/23007905/ Anesthesia for children with mitochondrial disorders: a national survey and review]

[https://pubmed.ncbi.nlm.nih.gov/32574972/ Sevoflurane as opposed to propofol anesthesia preserves mitochondrial function and alleviates myocardial ischemia/reperfusion injury]

Perioperative management of a child with short-chain acyl CoA dehydrogenase deficiency.
Pediatr Anesth 2005; 15: 771-7.

Hsieh VC, Krane EJ, Morgan PG. Mitochondrial disease and anesthesia. JIEMS. 2017;5:1–5

Kishikawa J-I, Inoue Y, Fujikawa M, Nishimura K, Nakanishi A, Tanabe T, et al. General anesthetics cause mitochondrial dysfunction and reduction of intracellular ATP levels. PLoS ONE. 2018;13:e0190213. doi: 10.1371/journal.pone.0190213

[https://pmc.ncbi.nlm.nih.gov/articles/PMC5278534 Anesthetic Management of a Child With Unspecified Mitochondrial Disease in an Outpatient Dental Setting]

[https://journals.lww.com/anesthesiology/abstract/2026/04000/effects_of_isoflurane_inhibition_of_mitochondrial.23.aspx Effects of Isoflurane Inhibition of Mitochondrial Complex I on Calcium Removal in Mouse Neuronal Cultures]

MT-ND4

[https://www.asahq.org/advocating-for-you/genetic-anesthesia-neurologic-mortality-risks ASA Information Page]

[https://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=9900&issue=00000&article=00979&type=Fulltext Editorial: Ancient Mitochondrial Genetic Variant, Modern-day Pandora’s Box]

[https://medlineplus.gov/genetics/gene/mt-nd4/ MT-ND4 gene: mitochondrially encoded NADH dehydrogenase 4]

[https://pedsanesthesia.net/forum/viewtopic.php?t=1352 Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children(Forum thread)]

[https://www.clinsurgeryjournal.com/index.php/ascr/article/view/ascr-aid1091/pdf Short Communication:Mitochondrial Genetic Susceptibility to Anesthetic Neurotoxicity in Venezuelan Pediatric Patients: A Call for Vigilance and Further Research]

[https://pedsanesthesia.org/joint-communication-from-the-society-for-pediatric-anesthesia-and-american-society-of-anesthesiologists-regarding-severe-neurological-complications-and-death-after-general-anesthesia-in-venezuelan-chi/ Joint Communication from the Society for Pediatric Anesthesia and American Society of Anesthesiologists Regarding Severe Neurological Complications and Death after General Anesthesia in Venezuelan Children]

[https://youtu.be/cKuFfUwxSx4?si=v-WqKAO5gQerTKwu Part of the webinar series Hot Topics in Pediatric Anesthesia, presented by the Pediatric Anesthesia Committee of the Florida Society of Anesthesiologists, Rosalie Tassone, MD, Chair. "Bad Outcomes in Strange Times - Update on the ASA/SPA Communications Regarding Pediatric Patients of Venezuelan Families" presented by Luis Rodriguez, MD (originally presented on November 12, 2025)]

[https://www.asahq.org/advocating-for-you/guidance/asa-spa-neurological Update regarding severe neurological complications and death after general anesthesia in adult and pediatric patients of Venezuelan ancestry (January 27, 2026)]

[https://journals.lww.com/anesthesiology/fulltext/9900/potential_mitochondrial_pharmacogenetic.904.aspx Potential Mitochondrial Pharmacogenetic Susceptibility to Severe Neurologic Events after General Anesthesia: Report from the Chilean Ministry of Health]

[https://www.pnas.org/doi/10.1073/pnas.1621511114 Hypoxia treatment reverses neurodegenerative disease in a mouse model of Leigh syndrome]

[https://pubmed.ncbi.nlm.nih.gov/37770252/ Volatile anaesthetic toxicity in the genetic mitochondrial disease Leigh syndrome]

[https://journals.lww.com/anesthesiology/abstract/9900/effects_of_a_mitochondrial_genetic_variant_on.912.aspx Effects of a mitochondrial genetic variant on sevoflurane hypersensitivity]

[https://esaic.org/joint-statement-on-anaesthesia-related-mitochondrial-pharmacogenetic-risk-in-individuals-with-venezuelan-maternal-ancestry/ ESAIC News: Joint Statement on Anaesthesia-Related Mitochondrial Pharmacogenetic Risk in Individuals with Venezuelan Maternal Ancestry]

[https://kevinmd.com/2026/04/how-a-hidden-genetic-mutation-creates-a-severe-pediatric-anesthesia-risk.html KevinMD: How a hidden genetic mutation creates a severe pediatric anesthesia risk]

[https://revistachilenadeanestesia.cl/revchilanestv55n2-18/ Recomendaciones anestésicas frente a una variante genética infrecuente en población con ascendencia venezolana, con posible asociación a complicaciones neurológicas severas tras anestesia general (Anesthetic recommendations regarding a rare genetic variant in a population with Venezuelan ancestry, with a possible association with severe neurological complications following general anesthesia]

[https://www.sciencedirect.com/science/article/abs/pii/S0034935626000708 Encefalopatía aguda asociada a anestesia general en un paciente adulto portador de la variante m.11232T>C en el gen MT-ND4 (An adult case of acute encephalopathy associated with general anesthesia and the m.11232T>C MT-ND4 variant)]

[https://tools.sodapdf.com/document/6287485d-7db3-42e5-90c2-8f668e846b4a Emerging Reports of Severe Neurological Complications Following General Anesthesia in Patients with Maternal Venezuelan Ancestry]

[https://player.vimeo.com/video/1179934920 Video for Parents (English)]

[https://player.vimeo.com/video/1179935060 Video for Parents (Español)]

[https://www.medscape.com/viewarticle/anesthetic-risk-linked-venezuelan-maternal-lineage-2026a10009ni?ecd=a2a&form=fpf Anesthetic Risk Linked to Venezuelan Maternal Lineage]

[https://journals.lww.com/monitor/fulltext/2026/03000/airs_case_2026_03__this_is_why_we_have_airs.10.aspx AIRS Case 2026-03: This Is Why We Have AIRS]

[https://www.apsf.org/article/perioperative-practices-for-patients-of-venezuelan-ancestry/ Perioperative Practices for Patients of Venezuelan Ancestry]

[https://sphere.nyssa-pga.org/2026/mitochondrial-genetic-susceptibility-to-anesthetics-in-patients-with-venezuelan-heritage/ Mitochondrial Genetic Susceptibility to Anesthetics in Patients with Venezuelan Heritage]

Sepsis

2026-04-29T23:09:13Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/38245889/ International Consensus Criteria for Pediatric Sepsis and Septic Shock]

[https://jamanetwork.com/journals/jama/fullarticle/2814296 Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock]

[https://www.sciencedirect.com/science/article/abs/pii/S0883944125002734 What every intensivist should know about the biphasic kinetics of lactate in septic shock]

[https://jamanetwork.com/journals/jama/fullarticle/2840821 Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock]

[https://www.nejm.org/doi/full/10.1056/NEJMoa2502136 Deferring Arterial Catheterization in Critically Ill Patients with Shock]

[https://www.sciencedirect.com/science/article/pii/S0883944125003405 What every intensivist should know about…methylene blue in septic shock]

[https://www.nejm.org/doi/full/10.1056/NEJMoa2601969 Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock]

Sepsis

2026-04-29T23:08:43Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/38245889/ International Consensus Criteria for Pediatric Sepsis and Septic Shock]

[https://jamanetwork.com/journals/jama/fullarticle/2814296 Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock]

[https://www.sciencedirect.com/science/article/abs/pii/S0883944125002734 What every intensivist should know about the biphasic kinetics of lactate in septic shock]

[https://jamanetwork.com/journals/jama/fullarticle/2840821 Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock]

[https://www.nejm.org/doi/full/10.1056/NEJMoa2502136 Deferring Arterial Catheterization in Critically Ill Patients with Shock]

[https://www.sciencedirect.com/science/article/pii/S0883944125003405 What every intensivist should know about…methylene blue in septic shock]

[https://www.nejm.org/doi/full/10.1056/NEJMoa2601969 https://www.nejm.org/doi/full/10.1056/NEJMoa2601969]

Fetal and Neonatal Arrhythmias

2026-04-29T16:36:31Z

WikiSysop:

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/26876124/ Fetal and Neonatal Arrhythmias]

[https://pubmed.ncbi.nlm.nih.gov/33470961/ Neonatal lupus erythematosus - practical guidelines]

[https://pubmed.ncbi.nlm.nih.gov/41233007/ Congenital Heart Block]

[https://pubmed.ncbi.nlm.nih.gov/16815568/ Congenital complete heart block and maternal connective tissue disease]

[https://pubmed.ncbi.nlm.nih.gov/17502039/ Epidemiology, etiology, detection, and treatment of autoantibody-associated congenital heart block in neonatal lupus]

[https://pubmed.ncbi.nlm.nih.gov/24665257/ Anesthetic management of a 2-day-old with complete congenital heart block]

Fetal and Neonatal Arrhythmias

2026-04-29T16:33:14Z

WikiSysop:

Fetal and Neonatal Arrhythmias

2026-04-29T16:31:25Z

WikiSysop:

Fetal and Neonatal Arrhythmias

2026-04-29T16:27:45Z

WikiSysop: Created page with "{{Stub Notice}} [https://pubmed.ncbi.nlm.nih.gov/26876124/ Fetal and Neonatal Arrhythmias]"

{{Stub Notice}}

[https://pubmed.ncbi.nlm.nih.gov/26876124/ Fetal and Neonatal Arrhythmias]

Main Page

2026-04-29T16:27:00Z

WikiSysop: /* Syndromes/Disorders */

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'''If you are interested in participating in this huge, Global project, please go ahead and [https://pedsanesthesia.net/wiki/index.php?title=Special:CreateAccount&returnto=Main+Page register]! If you are reluctant, please contact me [mailto:DrBobGreenberg@PedsAnesthesia.net here] or on the [https://pedsanesthesia.net/forum forum]. Authorship may be recognized by your institution and contribute to "published works" for academic promotion.'''

----

=Introductory Topics=
:[[Preface]]
:[[Disclaimer]]

:[[The Editing Team]]
:[[History of Pediatric Anesthesia]]
:[[Pediatric Anesthesia Worldwide]]
:[[Measuring Outcome in Pediatric Anesthesia]]
:[[Basic Pediatric Concepts]]

==Training/Education/Certification==
:[[The Making of a Pediatric Anesthesiologist]]
::[[Educational Principles]]
::[[Certification Processes]]
::[[The Anesthesia Workforce]]
::[[Transitioning to Practice]]
::[[Women in Anesthesia]]
::[[Transitioning to Retirement]]
:[[Certified Registered Nurse Anesthestists - CRNA]]
:[[Anaesthesia Associates - AA]]
:[[TYK About | Test Your Knowledge]]
:[[Managing Knowledge]]

==Basic Clinical Information [Outside Sources]==
:[[WFSA PaedsUpdateContents_30]] Volume 30 - June 2015 (Wiki Format)
:[[WFSA PaedsUpdateContents_37]] Volume 37 - October 2023 (Wiki Format) [https://www.dropbox.com/scl/fi/rdgiam3tv8jbzrsptdyoy/New-Update-37-Paediatrics.pdf?rlkey=unpir1ysnmx1xchwq7c3i0oxc&st=ttapqkxn&dl=0 (PDF Format)]
:[[WFSA PaedsUpdateContents_39]] [https://www.dropbox.com/scl/fi/he3ncg2uhwzdi91xh76ta/UIA-39-WORKFORCE-WELL-BEING.pdf?rlkey=y3alw1rxs7telzfdqjtadu6m7&st=y6gxzslh&dl=0 (PDF Format)]
:[https://www2.pedsanesthesia.org/lecture_series/ Society for Pediatric Anesthesia Lecture Series]
:[https://www.openanesthesia.org/ OpenAnesthesia]
:[https://learn.openpediatrics.org/pages/245/anesthesiology OpenPediatrics for Anesthesiology]
:[https://www.dropbox.com/scl/fi/uwlezdgx26ci6eddhnnba/Pediatric_20y_Comprehensive_Board_Review_-2015.pdf?rlkey=00d46xm9o68t7y4r8l0v35eu5&st=927c5vgv&dl=0 Pediatric Anesthesiology Comprehensive Board Review (Oxford)]
:ASA🔒 Resident Study Guides
::[https://education.asahq.org/mod/book/view.php?id=32940&chapterid=123 Peds Core Month One Curriculum]
::[https://education.asahq.org/mod/book/view.php?id=32940&chapterid=134 Peds Core Month 2 Curriculum]
::[https://education.asahq.org/mod/book/view.php?id=32940&chapterid=137 Peds Advanced Month 3 Curriculum]
:[[ABA Pediatric Anesthesiology Exam Content Outline]]

Textbooks
:[https://www.academia.edu/37973952/Manual_of_Pediatric_Anesthesia 📒 Practice of Anesthesia for Infants and Children, Seventh Edition (Lerman, Coté, Anderson)]

:[https://www.sciencedirect.com/book/9780323341257/smiths-anesthesia-for-infants-and-children 📒 Smith's Anesthesia for Infants and Children • Ninth Edition • 2017 (Davis and Cladis)]

:[https://monographs.ufs.ac.za/index.php/PASA/index 📒 Paediatric Anaesthesia for Southern Africa]

==The Growing Child==
:[[Embryology]]
:[[Development]]
:[[Growth]]
:[[Developmental Psychology]]

==Anatomy & Physiology==
:[[Respiratory System]]
:[[Cardiovascular System]]
:[[Renal System]]
:[[Endocrine System]]
:[[Nervous System]]
:[[Temperature Regulation]]
:[[Fluid & Electrolytes]]
:[[Coagulation & Bleeding]]
:[[Pharmacology]]
::[[Clinical Pharmacokinetics & Pharmacodynamics in children]]
::[[Anesthetic Agents]]
::[[Opiates & Sedatives]]
::[[Muscle Relaxants]]
:[[Epigenetics]]
:[[Infection Control]]
:[[Neurocognitive Risk]]

==Monitoring==
:[[Standard Monitoring]]
::[[Precordial Stethoscope]]
::[[Oxygen]]
::[[Electrocardiography - EKG]]
::[[Carbon Dioxide]]
::[[Blood Pressure]]
::[[Neuromuscular Blockade]]
::[[Temperature]]
:[[Neuromonitoring - IOM]]
:[[Thromboelastography - TEG]]
:[[Pacemakers]]
:[[Automated Internal Defibrillators]]
:[[Near-Infrared Spectroscopy]]
:[[Electroencephalography - EEG]]
:[[Precordial Doppler]]
:[[Depth of Anesthesia]]
::[[BIS]]
::[[SEDline]]
:[[Alarm Fatigue]]

==Ethical Issues in Pediatric Anesthesia==
:[[Ethical Constructs relevant to Pediatric Anesthesia]]
:[[The Emancipated Minor]]
:[[Assent/Consent]]
:[[The child of a Jehovah's Witness]]
:[[Anesthesia in Low Resource Settings]]
:[[Global Pediatric Anesthesia]]
:[[VIP Care]]
:[[End of Life]]
:[[Racial Disparities in Care]]
:[[Child Abuse, Neglect, and Protection]]

==Error, Judgement, and The Law==
:[[Errors in the Operating Room]]
::[[Wrong Side Procedures]]
:[[Just Culture]]
:[[The Making of Medical Malpractice Suit]]

=Clinical Techniques=
:[[Standards of Anesthesia]]
:[[Pocket Reference Cards]]
:[[Point of Care Ultrasound - POCUS]]
:[[Hypnosis]]
==Preoperative Assessment==
:[[General Preoperative Assessment]]
:[[Psychological Preparation of the Pediatric Patient & Family]]
:[[The Fetus]]
:[[The Pre-Term Infant]]
:[[The Infant]]
:[[The Child]]
:[[The Adolescent]]
:[[The Adult-aged Pediatric Patient]]
:[[The Former Premature Patient]]
:[[Upper Respiratory Infection]]
:[[Obstructive Sleep Apnea]]
:[[Preoperative Fasting]]
:[[Vaccination Status]]
:[[Child Trafficking]]
:[[Pregnancy Testing]]
:[[Social Determinants of Care]]
:[[Herbal Supplements]]

==Pre-anesthetic Medication==
:[[Pre-induction/Pre-medication]]

==Pediatric Sedation==
:[[Principles of Sedation]]
:[[Dental Sedation]]
:[[Sedation for Radiologic Procedures]]

==Ambulatory Anesthesia==
:[[Criteria for Outpatient Care]]
:[[Facility Requirements for Outpatient Care]]
:[[Risks/Advantages of Outpatient Care]]

==Anesthetic Induction==
:[[Physiology of Anesthesia]]
:[[Parental Presence During Induction]]
:[[Magic as a Distraction Technique]]
:[[Distracting Devices]]
:[[Psychological Preparation of the Pediatric Patient & Family]]

==Maintenance of Anesthesia==
:[[Fluid Management]]
:[[Neuromuscular Blockade]]
:[[Blood Products]]
::[[Massive Transfusion/Hemorrhage Protocol]]
::[[Reducing Blood Draw Anemia]]
::[[Blood Rheology]]
:[[Temperature Management]]
:[[Positioning]]
:[[Ventilation]]
::[[Breathing circuits]]
::[[Intraoperative Atelectasis]]
:[[Hypotension]]
::[[Controlled Hypotension]]
:[[Electrocautery]]
:[[Depth of Anesthesia]]
::[[BIS]]
::[[SEDline]]

Drugs
:[[Volatile Anesthetics]]
::[[Inhalational Induction]]
::[[Closed Circuit Anesthesia]]
::[[High Altitude Effects]]
:[[Propofol]]
:[[Dexmedetomidine]]
:[[Opiates]]
:[[Opioid Free Techniques]]
:[[Target Controlled Infusion - TCI]]
:[[Hypnosis]]
:[[Non-Steroidal Anti-inflammatory Agents]]
::[[Ketorolac]]
::[[Ibuprofen]]
::[[Cox-2 Inhibitors]]
:[[Ketamine]]
:[[Esmolol]]
:[[Adenosine]]
:[[Benzodiazepines]]
:[[Perioperative Steroids]]
:[[Antibiotics]]
:[[Acetaminophen]]
:[[Methylene Blue]]
:[[Insulin Pumps]]
:[[Parasympatholytics]]
:[[Bicarbonate]]
:[[Succinylcholine]]
:[[Antihistamines]]
:[[Rubber Coring]]

==Emergence/Recovery from Anesthesia==
:[[Deep Extubation]]
:[[Emergence Delirium]]
:[[Post Operative Nausea & Vomiting]]
:[[Pain Management in the Recovery Room]]
:[[Post Obstructive Pulmonary Edema]]
:[[Intraoperative Awareness and Recall]]
:[[Post Operative Apnea]]
:[[Early Mobilization]]

==Airway Management==
:[[Basic Airway Anatomy of the Pediatric Patient]]
:[[Syndromes and Airway Assessment]]
:[[Basic Airway Management of the Pediatric Patient]]
:[[Laryngeal Mask Airway]]
:[[Basic Laryngoscopy and Intubation]]
:[[Basic Nasal Intubation]]

:[[Rapid Sequence Induction]]

:[[Recognizing and Managing the Difficult Pediatric Airway]]

:[[Advanced Airway Techniques]]
:[[Airway POCUS]]

:[[Difficult Airway Response Teams]]
:[[One Lung Ventilation]]
:[[Cuffed vs Uncuffed ETTs]]

:[[Basic Ventilation]]
:[[Advanced Ventilation]]
:[[Emergency Airway Management]]
:[[Complications of Airway Management]]
:[[Laryngospasm]]
:[[Nebulization]]
:[[Extubation]]
:[[Deep Extubation]]

==Vascular Access==
:[[Intravenous catheter placement & Care]]
:[[Central Venous Catheter placement & Care]]
:[[Intraosseous Access & Care]]
:[[Arterial catheter placement & Care]]
:[[Intranasal Drug Delivery]]
:[[Needlestick Injury]]

==Regional Blockade==
:[[Principles of Regional Anesthesia in Children]]
:[[The use of Ultrasound for Regional Anesthesia]]
:[[Local Anesthetics in Children]]
::[[Topical Analgesics]]
:[[Local Anesthetic Adjuncts in Children]]
:[[Continuous Catheter Infusion (Outside of Hospital)]]
:[[Local Anesthetic Systemic Toxicity - LAST]]
:[[Nerve Complications of Regional Blockade]]
:[[Peripheral Nerve Stimulation]]
:[[Compartment Syndrome and Regional Blockade]]
:[[Post-Dural Puncture Headache]]
:[[Rebound Pain after Nerve Block]]
:[[Vasodilatory Effect of Blockade]]

Blocks:
:[[Axial Blockade]] ([[Caudal]], [[Lumbar Epidural]], [[Thoracic Epidural]], [[Spinal]], [[Combined Spinal/Caudal]])

:[[Head & Neck]] ([[Palatal]], [[Buccal]], [[Supraorbital & Trochlear Nerve Blocks]], [[Oral Nerve Blocks]], [[Superficial Cervical Plexus Block]], [[Suprazygomatic Maxillary Nerve]], [[Infraorbital Nerve Block]], [[Scalp Blocks]], [[Ophthalmic Blocks]])

:[[Upper Extremity]] ([[Interscalene]], [[Supraclavicular]], [[Infraclavicular]], [[Axillary]], [[Peripheral Arm]], [[Intravenous Regional (Bier)]])

:[[Thorax]] ([[Intercostal]], [[Paravertebral]], [[Erector Spinae Plane]], [[Pleural]], [[Pectoral]], [[Serratus Anterior]])

:[[Abdomen]] ([[Rectus Sheath]], [[Transversus Abdominus Plane]], [[Quadratus Lumborum]], [[Ileoinguinal/Ileohypogastric]], [[Pudendal]], [[Penile]])

:[[Lower Extremity]] ([[Lumbar Plexus]], [[PENG]], [[Femoral]], [[Adductor Canal]], [[4 in 1]], [[Sciatic]], [[Popliteal]], [[iPACK]], [[Ankle]])

==Blood Conservation Techniques==
:[[Cell Saver]]
:[[Controlled Hypotension]]
:[[Tranexamic Acid]]
:[[Reducing Blood Draw Anemia]]

==Cardiopulmonary Resuscitation==
:[[Intraoperative Cardiac Arrest]]
:[[Pediatric CPR]]
:[[Code Teams]]
:[[PALS Protocols]]
:[[Prone CPR]]
:[[ECMO]]
:[[CPR Coach]]
:[[Crisis Management]]
:[[Parental Presence During Resuscitation / CPR]]
:[[Breaking Bad News]]

=Syndromes/Disorders=
[https://sites.uclouvain.be/anesthweekly/MRP_ENG/index.html Syndromes & Rare Diseases in Pediatrics: Anesthesia]

[https://rarediseases.info.nih.gov/diseases/browse-by-first-letter Genetic and Rare Diseases Information Center]

[https://www.ncbi.nlm.nih.gov/books/NBK430685/ StatPearls (National Library of Medicine)]

[https://www.orphananesthesia.eu/en/home-2.html OrphanAnesthesia]

:[[Achalasia]]
:[[Achondroplasia]]
:[[Acute Flaccid Myelitis]]
:[[Adrenal Insufficiency]]
:[[Alagille Syndrome]]
:[[Alpha-Gal Syndrome]]
:[[Anaphylaxis]]
:[[Anencephaly/Hydranencephaly]]
:[[Angelman Syndrome]]
:[[anti-NMDA receptor encephalitis]]
:[[Apert Syndrome]]
:[[Asthma]]
:[[Autism Spectrum]]
:[[Beckwith-Wiedemann syndrome]]
:[[Bronchopulmonary Dysplasia]]
:[[Brugada Syndrome]]
:[[Cardiac Tamponade]]
:[[Cardiomyopathy]]
:[[Cerebral Palsy]]
:[[CHARGE association]]
:[[Charcot-Marie-Tooth Disease]]
:[[Cleft lip and/or palate]]
:[[Cleidocranial dysplasia]]
:[[Cocaine Use]]
:[[Conjoined Twins]]
:[[Cornelia de Lange Syndrome]]
:[[COVID]]
:[[Craniosynostosis]]
:[[Croup]]
:[[Cystic Fibrosis]]
:[[DiGeorge syndrome (22q11.2 deletion syndrome)]]
:[[Diabetes]]
:[[Disseminated Intravascular Coagulation]]
:[[Down Syndrome]]
:[[Duchenne muscular dystrophy]]
:[[Early (J Point) Repolarization]]
:[[Ehlers-Danlos Syndrome]]
:[[Epidermolysis Bullosa]]
:[[Factor V Leiden]]
:[[Fanconi Anemia]]
:[[Fetal and Neonatal Arrhythmias]]
:[[Freeman-Sheldon Syndrome]]
:[[Genetic Disease]]
:[[G6PD]]
:[[Goldenhar syndrome]]
:[[Guillain–Barré syndrome]]
:[[Hereditary Angioedema]]
:[[Hereditary Spherocytosis]]
:[[Heterotaxy Syndrome]]
:[[Hiccups]]
:[[Inherited metabolic disorders]]
:[[Intrauterine Drug Exposure]]
:[[Kartagener's syndrome]]
:[[Ketogenic Diet]]
:[[Klippel-Feil syndrome]]
:[[Klippel-Trenaunay syndrome]]
:[[Leigh’s Syndrome]]
:[[Lennox-Gastaut syndrome]]
:[[Long QT Syndrome]]
:[[Malignant Hyperthermia]]
:[[Marijuana Use]]
:[[Mastocytosis]]
:[[Measles]]
:[[Medical Child Abuse]]
:[[Medium-chain acyl-CoA Dehydrogenase Deficiency]]
:[[Menkes Disease]]
:[[Mesenteric Traction Syndrome]]
:[[Minimal Change Disease]]
:[[Mitochondrial Disease]]
:[[Möbius syndrome]]
:[[Monkeypox]]
:[[Moya Moya Syndrome]]
:[[Mucopolysaccharidoses]]
:[[Myasthenia Gravis]]
:[[Myotonic dystrophies]]
:[[Nephrotic Syndrome]]
:[[Neuroleptic Malignant Syndrome]]
:[[Niemann-Pick Disease]]
:[[Nonaccidental Trauma]]
:[[Noonan syndrome]]
:[[Obesity]]
:[[Obstructive Sleep Apnea]]
:[[Ophthalmologic Disease]]
:[[Osteogenesis imperfecta]]
:[[Pacemakers]]
:[[Papillomatosis]]
:[[Patent Ductus Arteriosus]]
:[[Periodic Fever Syndromes]]
:[[Pheochromocytoma]]
:[[Pierre Robin sequence]]
:[[Polycythemia Vera]]
:[[Porphyria]]
:[[Postural orthostatic tachycardia syndrome (POTS)]]
:[[Prader-Willi Syndrome]]
:[[Priapism]]
:[[Pseudocholinesterase Deficiency]]
:[[Pulmonary Hypertension]]
:[[Red-Head (MC1R) variant]]
:[[Renal Agenesis]]
:[[Retinopathy of Prematurity]]
:[[Rett Syndrome]]
:[[Rubinstein-Taybi Syndrome]]
:[[Sepsis]]
:[[Sickle Cell Disease]]
:[[Smoking and Vaping]]
:[[Special Needs]]
:[[Spina Bifida]]
:[[Spinal Cord Injury]]
:[[Spinal Muscular Atrophy]]
:[[Stevens-Johnson Syndrome]]
:[[Stickler Syndrome]]
:[[Stroke]]
:[[Sturge Weber]]
:[[Substance Use Disorder]]
:[[Tetanus]]
:[[Thyrotoxicosis]]
:[[Treacher Collins syndrome]]
:[[Trochlear Palsey]]
:[[Tuberous Sclerosis]]
:[[Tumor Lysis Syndrome]]
:[[Turner syndrome]]
:[[VACTERR (or VACTERL) association]]
:[[Vein of Galen Malformation]]
:[[Venous Thromboembolism]]
:[[Von Hippel-Lindau Syndrome]]
:[[Von Willibrand’s Disease]]
:[[Waardenburg syndrome]]
:[[Williams Syndrome]]
:[[Wolff-Parkinson-White syndrome]]

=Procedure Based Discussions=
:[[Generalized Suggested Outline]]

==General Surgery==
:[[Appendectomy]]
:[[Bariatric]]
:[[Bronchoscopy]]
:[[Burns]]
:[[Button Battery Ingestion]]
:[[Central Line Placement (Hickman/Broviac/Infusaport)]]
:[[Chest Tube - Thoracentesis]]
:[[Cholelithiasis]]
:[[Cystic Adenomatous Malformation (CAM)]]
:[[Diaphragmatic Hernia]]
:[[Duodenal Atresia]]
:[[Gastrochisis]]
:[[Inguinal Hernia]]
:[[Kasai Procedure]]
:[[Laparoscopy]]
:[[Magnet Ingestion]]
:[[Malrotation]]
:[[Necrotizing Enterocolitis]]
:[[Neuroblastoma]]
:[[Omphalocoele]]
:[[Ovarian Torsion]]
:[[Pectus Excavatum/Carinatum]]
:[[Pheochromocytoma]]
:[[Pyloric Stenosis]]
:[[Sacrococcygeal Teratoma]]
:[[Thoracotomy]]
:[[Thymectomy]]
:[[Thyroid/Parathyroid]]
:[[Tracheo-Esophageal Fistula]]
:[[Tracheopexy]]
:[[Trauma]]
:[[Umbilical Hernia]]
:[[Umbilical Herniorrphy]]

==Transplant==
:[[Liver Transplant]]
:[[Renal Transplant]]
:[[Cardiac Transplant]]
:[[Organ Procurement]]

==Otolarngology/Head & Neck Surgery(ENT)==
:[[Auditory Evoked Potentials]]
:[[Bleeding Upper Airway]]
:[[Bone Anchored Hearing Aid (BAHA)]]
:[[Bronchoscopy]]
:[[Cricoid Split Procedure]]
:[[Drug-induced sleep endoscopy (DISE)]]
:[[Epiglottitis]]
:[[EXIT Procedure]]
:[[Foreign Body in Airway]]
:[[Glottic Web]]
:[[Hypoglossal Nerve Stimulators]]
:[[Laryngotracheal Reconstruction]]
:[[Mastoidectomy]]
:[[Myringotomy Tubes]]
:[[Papillomatosis]]
:[[Retropharyngeal Abscess]]
:[[Suspension Micro Laryngoscopy]]
:[[Thyroglossal Duct Cyst]]
:[[Tonsillectomy/Adenoidectomy]]
:[[Tracheostomy]]
:[[Vallecular Cyst]]

==Fetal==
:[[Fetal Interventions]]
:[[ex utero intrapartum treatment (EXIT)]]

==Dental/Oral Surgery==
:[[Dental Restoration]]
:[[Dental Extraction]]
:[[Dental Sedation]]

==Orthopedics==
:[[Idiopathic Scoliosis]]
:[[Neuromuscular Scoliosis]]
:[[Slipped Capital Femoral Epiphysis]]
:[[Upper Extremity Fracture]]
:[[Lower Extremity Fracture]]
:[[Bone Cement]]
:[[Compartment Syndrome]]
:[[Tourniquet Use]]
:[[Clubfoot Repair]]
:[[Total Knee Arthroplasty]]
:[[Anterior Cruciate Ligament Repair]]

==Neurosurgery==
:[[General Neurosurgery]]
:[[Brain Tumor Craniotomy]]
:[[Arnold Chiari Malformation]]
:[[Ventriculo-Peritoneal Shunt]]
:[[Spinal Cord Untethering]]
:[[Encephalocele]]
:[[Spinal Cord Injury]]
:[[Awake Craniotomy]]
:[[Vagal Nerve Stimulator]]
:[[Arteriovenous Malformation]]
:[[Traumatic Brain Injury]]
:[[Air Embolism]]
:[[Spina Bifida - Myelomeningocele]]
:[[Pituitary Surgery]]
:[[Craniosynostosis]]
:[[Tethered Cord]]
:[[Rhizotomy]]

==Plastics==
:[[Craniosynostosis]]
:[[Craniofacial Reconstruction]]
:[[Cleft lip and/or palate]]
:[[LeFort Advancement]]
:[[Pierre Robin Mandibular Distraction]]
:[[Septo-Rhinoplasty]]
:[[Dermatologic Laser Therapy]]

==Urology==
:[[Circumcision]]
:[[Inguinal Hernia]]
:[[Cystoscopy]]
:[[Hypospadias]]
:[[Ureteral Re-Implantation]]
:[[Bladder Augmentation]]
:[[Neonatal Exstrophy]]
:[[Testicular Torsion]]
:[[Orchiopexy]]
:[[Robotic Surgery]]

==Transgender Topics==
:[[Transgender Terminology]]
:[[Assessment of the Transgender Patient]]
:[[Gender Confirming Therapies]]
::[[Hormone Therapy]]
::[[Feminizing Procedures]]
::[[Masculinizing procedures]]
::[[Perioperative Care]]

==Ophthalmology==
:[[Strabismus]]
:[[Glacoma]]
:[[Retina]]
:[[Retinoblastoma]]
:[[Nasolacrimal Duct]]
:[[Ptosis]]
:[[Open Globe]]
:[[Orbital Trauma/Fracture]]

==Cardiac/Congenital Heart Disease==
:[[Basic Cardiac Principles]]
:[[Transitional Circulation]]
:[[Cyanotic Lesions]]
:[[Non-cyanotic Lesions]]
:[[Cardiopulmonary Bypass]]
:[[Cardiac Catheterization]]
:[[Non-Cardiac Procedures]]

==Gastroenterology==
:[[Upper Endoscopy]]
:[[Lower Endoscopy/Colonoscopy]]
:[[Endoscopic Retrograde Cholangio-Pancreaticogram]]
:[[Liver Biopsy]]

==Oncology==
:[[Perioperative Care of the Child with Cancer]]
:[[Lumbar Puncture]]
:[[Bone Marrow Aspirate/Biopsy]]
:[[Bone Marrow Harvest]]
:[[Anterior Mediastinal Mass]]
:[[Wilms’ Tumor]]
:[[Radiation Therapy]]

==Robotic Surgery==
:[[Principles/Physiology]]
:[[Urology]]
:[[Orthopedics]]
:[[General Surgery]]

==Maternal-Fetal==
:[[Introduction to Fetal Anesthesia]]
:[[Pre-Partum Procedures]]
:[[Ex utero intrapartum treatment (EXIT)]]

==Radiology==
:[[Interventional Radiology]]
::[[Gastic-Jejunal Feeding Tube Insertion]]
::[[Vascular/Lymphatic Malformation]]
::[[Whitaker Procedure]]
::[[Percutaneous Nephrostomy]]
::[[Endovascular Liver Biopsy]]
::[[Cyst Drainage]]

:[[Magnetic Resonance Imaging]]
::[[Head/Body]]
::[[Cardiac MRI]]
:[[Positron Emission Tomography (PET)]]

:[[Neuroradiology]]
::[[Wada Test]]
::[[Vein of Galen Malformation]]
::[[Ophthalmic Artery Injection]]

:[[Urodynamic Studies]]
:[[Varicocele]]

==Psychiatry==
:[[Electroconvulsive Therapy]]

==Pain Management==
:WFSA: [[Perioperative analgesic pharmacology in children]]
:[[Overview of Pain in Children]]
:[[Factors that Modulate Pediatric Pain]]
:[[Assessment of Pain in Children]]
:[[Multimodal Pain Management in Children]]
:[[Pain Treatment in Children]]
::[[Acute Pain]]
:::[[Surgical]]
:::[[Medical]]
::[[Chronic Pain]]
:::[[Acute Pain that Becomes Chronic]]
:::[[Surgical]]
:::[[Medical]]
:[[Patient/Nurse/Parent Controlled Analgesia]]
:[[Patient Controlled Epidural Anesthesia]]
:[[Cancer Pain]]
:[[Hypnosis]]
:[[Honey]]
:[[Pain Management in the Intensive Care Unit]]
:[[Cryoanalgesia]]

==Palliative Care==
:[[Principles of Pediatric Palliative Care]]
:[[Transitioning to Palliative Care]]
:[[Setting Goals]]
:[[Techniques in the Palliative Setting]]
:[[End of Life Care]]
:[[Futile Care]]

=Operational/Procedural Topics=

==Care of the Pediatric Anesthesiologist==
:[[Ergonomics and Physical Factors]]
:[[Psychologic Stress]]
:[[Imposter Syndrome]]
:[[Diversity, Equity, and Inclusion]]
:[[Clinical Decision-Making]]
:[[Performance and Compensation]]
:[[The Aging Anesthesiologist]]
:[[Academic Matters]]

==Operating Suite Design and Implementation==
:[[Medical Language Interpretation]]
:[[Pre-operative Evaluation Center]]
:[[Pre-operative In-Take]]
:[[Operating Room Design]]
:[[Post-anesthesia Care Unit]]
:[[Remote Anesthesia Locations]]
::[[Radiology]]
::[[Magnetic Resonance Suite]]
::[[Cardiac Catheterization]]
::[[Pet Scanner]]
::[[CT Scanner]]
::[[Emergency Department]]
::[[Office-based Practice]]
:[[Scheduling Strategies]]
:[[Environmental and Occupational Considerations]]
:[[Intraoperative Communication]]
:[[Personal Electronic Devices]]

==Sedation of the Pediatric Patient==
:[[Transporting the anesthetized Pediatric Patient]]
:[[Dental Sedation]]
:[[Creating a Sedation Service]]

==Recovery of the Pediatric Patient==
:[[Post Operative Nausea & Vomiting]]
:[[Pain Management in the Recovery Room]]
:[[Post-Operative Nursing Care]]
:[[Emergence Delirium]]
:[[Delayed Emergence]]
:[[Post-Operative Behavior Changes]]

==Personnel Safety in the Pediatric Environment==
:[[Operating Room Fires]]
:[[Active Shooter]]
:[[Magnetic Resonance Imaging - MRI]]
:[[X-Ray & Radiologic Safety]]

==Special Topics in Mass Casualty Incidents==

:[[Principles of MCI and Pediatrics]]

:[[Helicopter Emergency Medical Services- HEMS]]

==Low Resource Environments==
:[[Low Resource Environment Issues]]
:[[In-Flight Emergencies]]

==The Pediatric Perioperative Surgical Home==
:[[Enhanced Recovery After Surgery - ERAS]]
:
----

=Editing tools=
:[[TYK_Question_List]]
:[[Working Sandbox]]

Principles of Regional Anesthesia in Children

2026-04-28T14:19:11Z

WikiSysop:

{{Stub Notice}}

[https://rapm.bmj.com/content/early/2023/11/22/rapm-2023-104884 Standardizing nomenclature in regional anesthesia: an ASRA-ESRA Delphi consensus study of upper and lower limb nerve blocks]

[https://www.nysora.com/topics/sub-specialties/pediatric-anesthesia/peripheral-nerve-blocks-children/ NYSSORA: Peripheral Nerve Blocks for Children]

[https://www.baby-blocks.com/ Baby Blocks][https://www.baby-blocks.com/en-espanol en Español]

[https://pubmed.ncbi.nlm.nih.gov/31268173/ Future directions in regional anaesthesia: not just for the cognoscenti]

[https://pubmed.ncbi.nlm.nih.gov/36049876/ Unique Issues Related to Regional Anesthesia in Pediatric Orthopedics]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/abs/10.1111/anae.15876 New blocks on the kids: core basic nerve blocks in paediatric anaesthesia]

[https://resources.wfsahq.org/atotw/principles-of-regional-anaesthesia-in-children/ WFSA: Principles of Regional Anaesthesia in Children]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.12424 A national survey of aseptic precautions for pediatric caudal blockade]

[https://pubmed.ncbi.nlm.nih.gov/26192549/ The European Society of Regional Anaesthesia and Pain Therapy and the American Society of Regional Anesthesia and Pain Medicine Joint Committee Practice Advisory on Controversial Topics in Pediatric Regional Anesthesia]

[https://pubmed.ncbi.nlm.nih.gov/35313269/ Practice advisory on the prevention and management of complications of pediatric regional anesthesia]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15283 Fundamentals and innovations in regional anaesthesia for infants and children]

[https://pubs.asahq.org/anesthesiology/article/123/1/38/12482/Apnea-after-Awake-Regional-and-General-Anesthesia Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study—Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15244 Contemporary training methods in regional anaesthesia: fundamentals and innovations]

[https://rapm.bmj.com/content/rapm/43/3/263.full.pdf Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines]

[https://www.bjanaesthesia.org/article/S0007-0912(23)00567-6/fulltext Peripheral regional anaesthesia and outcomes: a narrative review of the literature from 2013 to 2023]

[https://journals.lww.com/clinicalpain/fulltext/2024/02000/perioperative_regional_anesthesia_pain_outcomes_in.2.aspx Perioperative Regional Anesthesia Pain Outcomes in Children: A Retrospective Study of 3160 Regional Anesthetics in Routine Practice]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00262-9/fulltext The educational impact of technology-enhanced learning in regional anaesthesia: a scoping review]

[https://journals.lww.com/anesthesia-analgesia/fulltext/9900/perioperative_regional_anesthesia_on_persistent.928.aspx Perioperative Regional Anesthesia on Persistent Opioid Use and Chronic Pain after Noncardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials]

[https://www.bjanaesthesia.org/article/S0007-0912(24)00549-X/fulltext Classification system for failed peripheral nerve blocks]

[https://rapm.bmj.com/content/early/2025/01/14/rapm-2024-105651 ASRA Pain Medicine consensus practice infection control guidelines for regional anesthesia and pain medicine]
[https://rapm.bmj.com/content/early/2025/07/21/rapm-2025-106770 Infographics]

[https://rapm.bmj.com/content/early/2024/12/31/rapm-2024-105862 Risk profiles of common brachial plexus block sites: results from the net-ra registry]

[https://rapm.bmj.com/content/early/2025/01/21/rapm-2024-105766 Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (fifth edition)]

[https://rapm.bmj.com/content/early/2025/03/31/rapm-2025-106434 Baby steps to mastery: building blocks for novices in pediatric regional anesthesia]

[https://journals.lww.com/anesthesiology/fulltext/9900/pediatric_regional_anesthesia__a_practical.702.aspx Pediatric Regional Anesthesia: A Practical Guideline for Daily Clinical Practice] [https://journals.lww.com/anesthesiology/fulltext/9900/pediatric_regional_anesthesia__comment.870.aspx Comment] [https://journals.lww.com/anesthesiology/fulltext/9900/pediatric_regional_anesthesia__reply.872.aspx Reply]

[https://onlinelibrary.wiley.com/doi/10.1111/pan.70000 Regional Anesthesia in Resource-Constrained Settings: A Chance to Ameliorate Pediatric Perioperative Care]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.16691 Regional anaesthesia for awake surgery in children: we can, but should we?]

[https://rapm.bmj.com/content/early/2025/07/21/rapm-2025-106770 ASRA Pain Medicine Consensus Practice Infection Control guidelines]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16781 Towards a comprehensive and efficient assessment of regional anaesthesia competency]

[https://pubmed.ncbi.nlm.nih.gov/31573994 Variation Between and Within Hospitals in Single Injection Caudal Local Anesthetic Dose: A Report From the Pediatric Regional Anesthesia Network]

[https://pubmed.ncbi.nlm.nih.gov/30074928 Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network]

[https://pubmed.ncbi.nlm.nih.gov/24918334 Asleep versus awake: does it matter?: Pediatric regional block complications by patient state: a report from the Pediatric Regional Anesthesia Network]

[https://pubmed.ncbi.nlm.nih.gov/22696610 Pediatric Regional Anesthesia Network (PRAN): a multi-institutional study of the use and incidence of complications of pediatric regional anesthesia]

Ecoffey C, Bosenberg A, Lonnqvist PA, Suresh S, Delbos A, Ivani G. Practice advisory on the prevention and management of complications of pediatric regional anesthesia. J Clin Anesth. 2022 Aug; 79: 110725. PMID: 35313269

Chlorhexidine gluconate (topical): pediatric drug information. In: UpToDate. Waltham, MA: UpToDate. Topic last updated December 6, 2022.

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.70090 Towards a dedicated quality of recovery scale for regional anaesthesia]

[https://x.com/kartikbsonawane/status/2048846397395640417?s=46&t=X_9iaGrsYZbY5PJKh6nAPQ Wrong side block]