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Perioperative intravenous lignocaine for pediatric postoperative pain-A systematic review and meta-analysis. 围手术期静脉注射木质素卡因治疗小儿术后疼痛--系统综述和荟萃分析。
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-04 DOI: 10.1111/pan.15015
Aakriti Gupta, Vighnesh Ashok

Background: Intravenous lignocaine has been used as an analgesic adjunct in pediatric surgical patients, although its efficacy is still unclear.

Objective: We aimed to clarify the efficacy of perioperative intravenous lignocaine (bolus followed by an infusion) on pediatric postoperative pain outcomes.

Design: A systematic review and meta-analysis.

Data sources: PubMed, EMBASE, Web of Science, Google Scholar (inception to June 2024).

Eligibility criteria: Studies involving pediatric patients (≤18 years) undergoing surgery under general anesthesia with one group receiving perioperative intravenous lignocaine (bolus followed by infusion) and the other group receiving placebo. The primary outcome was 24-h postoperative opioid consumption. Postoperative pain scores and the need for rescue analgesia were the secondary outcomes.

Results: Seven studies (n = 415) were included in the final meta-analysis. The use of intravenous lignocaine significantly reduced the morphine consumption in the first 24 h after surgery, compared to placebo (SMD -1.31, 95% CI -2.18 to -0.43, p = 0.003). A meta-analysis could not be performed for the secondary outcomes.

Conclusion: There is low quality evidence to suggest that perioperative intravenous lignocaine bolus followed by an infusion significantly reduced the opioid consumption on the first postoperative day in pediatric surgical patients. The effects of perioperative lignocaine on postoperative pain scores and the need for rescue analgesia are uncertain.

背景:静脉注射木质素卡因已被用作儿科手术患者的镇痛辅助药物,但其疗效仍不明确:我们旨在明确围手术期静脉注射木质素(栓剂后输注)对小儿术后疼痛结果的疗效:设计:系统回顾和荟萃分析:数据来源:PubMed、EMBASE、Web of Science、Google Scholar(开始至 2024 年 6 月):涉及在全身麻醉下接受手术的儿科患者(≤18 岁)的研究,其中一组患者在围手术期静脉注射利格诺卡因(栓剂后输注),另一组患者服用安慰剂。主要结果是术后24小时的阿片类药物消耗量。术后疼痛评分和抢救性镇痛需求是次要结果:最终荟萃分析纳入了七项研究(n = 415)。与安慰剂相比,静脉注射木质素可显著减少术后头24小时的吗啡用量(SMD -1.31,95% CI -2.18 to -0.43,p = 0.003)。无法对次要结果进行荟萃分析:有低质量证据表明,围手术期静脉注射木质素后再输液可显著减少小儿外科手术患者术后第一天的阿片类药物用量。围手术期使用木质素卡因对术后疼痛评分和抢救性镇痛需求的影响尚不确定。
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引用次数: 0
Common error traps in anesthesia for neonatal surgical emergencies. 新生儿外科急症麻醉中的常见错误陷阱。
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-06 DOI: 10.1111/pan.15029
Tyler Morrissey, Fiona Taverner, Anthony Sawyer, Kim Strupp

Neonatal surgical emergencies are challenging, often high-risk procedures for the pediatric anesthesiologist. Though each emergency presents different anesthetic challenges, several error traps exist that are common to all procedures in this patient population. These error traps include errors in surgical timing, airway management, maintenance of normothermia and normoglycemia, and recognition of pharmacologic and physiologic differences. In this narrative review, we will discuss each error trap to aid the clinician in recognizing, planning for, and mitigating adverse events.

对于儿科麻醉医生来说,新生儿外科急诊具有挑战性,通常是高风险手术。虽然每种急诊都会带来不同的麻醉挑战,但在这一患者群体的所有手术中都存在一些常见的错误陷阱。这些错误陷阱包括手术时机、气道管理、维持体温正常和血糖正常以及识别药理和生理差异方面的错误。在这篇叙述性综述中,我们将讨论每个错误陷阱,以帮助临床医生识别、计划和减轻不良事件。
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引用次数: 0
Long-term maintenance-related complications of brachiocephalic vein cannulations in neonates: A retrospective evaluation. 新生儿肱脑静脉插管的长期维护相关并发症:回顾性评估
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-07 DOI: 10.1111/pan.15018
Eser Simsek, Filiz Uzumcugil, Sule Yigit

Background: Neonates are relatively prone to immediate, early, and late complications related to central venous cannulation (CVC). Ultrasound-guided brachiocephalic vein (BCV) cannulation has proven to be safe in neonates. Although studies addressed the immediate and early complications of CVC via BCV in neonates, few explored long-term maintenance-related complications.

Aims: To evaluate the incidences of long-term maintenance-related complications including central line-associated blood stream infection (CLABSI), central line-associated thrombosis (CLAT), and mechanical complications (CLAMC) of nontunneled BCV cannulation in neonates and their relationship with patient and catheter-related factors.

Methods: This study included BCV cannulations of neonates with postconceptional age of ≤44 weeks performed between January 2018 and January 2023. The incidences of complications were determined. Correlations between complications and postconceptional age, body weight, indication for catheter placement, the size and side of the catheter, as well as catheter dwell time were analyzed.

Results: In total, 89 BCV cannulations performed in 71 neonates. The incidences were 19.3 [95%CI: 12.88-28.76] total complications, 5.9 [95%CI: 2.84-12.06] CLABSI, 3.4 [95%CI: 1.30-8.58] CLAT and 10.1 [95%CI: 5.76-17.49] CLAMC in 1000 catheter days. There were 23 (25.8%) total complications; 7 (7.9%) were CLABSI, 4 (4.5%) were CLAT, and 12 (13.5%) were CLAMC. The multivariate analysis revealed that prolonged dwell time was associated with high incidence of total complications [OR: 1.07, 95% CI: 1.00-1.14, p = .047] and the catheter of smaller size (3F in this study) was associated with higher incidence of CLABSI [OR: 8.91, 95% CI: 1.03-77.45, p = .047].

Conclusion: In this study, the prolonged dwell time and smaller sized catheter was found to be independent predictors of total complications and CLABSI, respectively. The independent predictive effects of postconceptional age and body weight should be addressed in larger studies as potential risk factors.

背景:新生儿相对容易出现与中心静脉插管(CVC)相关的即刻、早期和晚期并发症。事实证明,超声引导下的肱脑静脉(BCV)插管对新生儿是安全的。目的:评估新生儿非隧道式 BCV 插管的长期维护相关并发症(包括中心静脉相关血流感染(CLABSI)、中心静脉相关血栓形成(CLAT)和机械并发症(CLAMC))的发生率及其与患者和导管相关因素的关系:本研究纳入了 2018 年 1 月至 2023 年 1 月期间对受孕后年龄≤44 周的新生儿进行的 BCV 插管。确定了并发症的发生率。分析了并发症与受孕后年龄、体重、导管放置指征、导管尺寸和侧边以及导管停留时间之间的相关性:71名新生儿共进行了89次BCV插管。结果:71 名新生儿共进行了 89 次 BCV 插管,总并发症发生率为 19.3 [95%CI:12.88-28.76],CLABSI 为 5.9 [95%CI:2.84-12.06],CLAT 为 3.4 [95%CI:1.30-8.58],CLAMC 为 10.1 [95%CI:5.76-17.49]。总并发症为 23 例(25.8%),其中 7 例(7.9%)为 CLABSI,4 例(4.5%)为 CLAT,12 例(13.5%)为 CLAMC。多变量分析显示,停留时间延长与总并发症发生率高相关[OR:1.07,95% CI:1.00-1.14,p = .047],导管尺寸较小(本研究中为 3F)与 CLABSI 发生率较高相关[OR:8.91,95% CI:1.03-77.45,p = .047]:本研究发现,停留时间延长和导管尺寸变小分别是总并发症和 CLABSI 的独立预测因素。孕后年龄和体重作为潜在风险因素的独立预测作用应在更大规模的研究中加以探讨。
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引用次数: 0
Erector spinae plane block versus intravenous opioid for analgesia in pediatric cardiac surgery: A systematic review and meta-analysis. 小儿心脏手术中脊柱后凸平面阻滞与静脉注射阿片类药物镇痛的比较:系统回顾和荟萃分析。
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-15 DOI: 10.1111/pan.15027
Rafael A Lombardi, Eduardo M Pereira, Sara Amaral, Heitor J S Medeiros, Walid Alrayashi

Introduction: The erector spinae plane block (ESPB) has recently emerged as a regional anesthesia technique for perioperative pain management in pediatric cardiac surgery. However, evidence comparing its effectiveness with intravenous (IV) opioid-based analgesia is limited. We aimed to evaluate and compare the analgesic efficacy of ESPB versus IV opioids in this setting.

Methods: We systematically reviewed and meta-analyzed studies comparing ESPB with IV opioid analgesia in pediatric cardiac surgeries with midline sternotomy. Primary outcomes were intraoperative fentanyl consumption and intensive care unit (ICU) length of stay (LOS). Secondary outcomes included postoperative opioid consumption, time to first rescue analgesia, pain scores, postoperative vomiting and other complications, extubation time, and hospital LOS. Statistical analyses were performed using RStudio version 4.2.3.

Results: Five studies with 384 patients were included, with 178 receiving ESPB. ESPB significantly reduced intraoperative fentanyl use (MD -1.90 μg.kg-1; 95% CI -3.15 to -0.66 μg.kg-1; p = .003; I2 = 58%) and ICU LOS (MD -3.50 h; 95% CI -4.32 to -2.69 h; p < .0001; I2 = 0%). No significant differences were found in the remaining outcomes.

Conclusion: Our findings suggest the ESPB might be an important adjunct to enhancing analgesia for midline sternotomies in pediatric cardiac surgery, potentially reducing intraoperative opioid requirements and ICU LOS.

Prospero registration: CRD 42024526961.

简介:竖脊肌平面阻滞(ESPB)是最近兴起的一种区域麻醉技术,用于小儿心脏手术围手术期的疼痛治疗。然而,将其与静脉注射阿片类药物镇痛效果进行比较的证据非常有限。我们旨在评估和比较ESPB与静脉注射阿片类药物在这种情况下的镇痛效果:我们系统地回顾并荟萃分析了在采用胸骨中线切开术的小儿心脏手术中比较ESPB与静脉注射阿片类药物镇痛的研究。主要结果是术中芬太尼用量和重症监护室(ICU)住院时间(LOS)。次要结果包括术后阿片类药物消耗量、首次抢救镇痛时间、疼痛评分、术后呕吐和其他并发症、拔管时间和住院时间。统计分析使用 RStudio 4.2.3 版本进行:5项研究共纳入384名患者,其中178名患者接受了ESPB治疗。ESPB明显减少了术中芬太尼的使用量(MD -1.90 μg.kg-1;95% CI -3.15 to -0.66 μg.kg-1;p = .003;I2 = 58%)和ICU LOS(MD -3.50 h;95% CI -4.32 to -2.69 h;p 2 = 0%)。其余结果无明显差异:我们的研究结果表明,ESPB可能是加强小儿心脏手术中线胸骨切开镇痛的重要辅助工具,有可能减少术中阿片类药物的需求和ICU LOS:CRD 42024526961。
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引用次数: 0
The Pediatric Anesthesiology Workforce in the United States: How to Curb the Crisis?
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-12-17 DOI: 10.1111/pan.15056
Irim Salik, Tara Doherty, Apolonia E Abramowicz
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引用次数: 0
Perioperative Methadone for Posterior Spinal Fusion in Adolescents-Response to Letter to the Editor.
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-12-13 DOI: 10.1111/pan.15055
Keri R Hainsworth, Roger A Fons, Megan Jablonski, Michelle L Czarnecki, Steven J Weisman
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引用次数: 0
Use of Upper Extremity Electromyography Twitch Monitoring in a Patient With Goldenhar Syndrome and Absent Thumbs.
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-12-12 DOI: 10.1111/pan.15054
Mojca H Remskar, Jessica White
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引用次数: 0
The Newborn Infant Parasympathetic Evaluation Index for Assessment of Procedural Pain and Discomfort in Mechanically Ventilated Pediatric Intensive Care Patients: A Prospective, Exploratory, Observational Study.
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-12-07 DOI: 10.1111/pan.15050
Frank Weber, Emma Langen, Thomas Kerbusch, Eric Bokhorst

Background: The heart rate variability-based Newborn Infant Parasympathetic Evaluation (NIPE) Index is a continuous noninvasive tool for the assessment of pain and discomfort in infants. Little is known about its performance in the pediatric intensive care unit (PICU) setting, where assessment of pain/discomfort is usually based on discontinuous observational scoring systems or personal experience of medical staff.

Aim: Evaluation of the performance of NIPE as an indicator of procedural pain and/or discomfort in conscious mechanically ventilated PICU patients.

Methods: Procedural pain/discomfort was simultaneously assessed during pain- or stressful procedures by two validated discontinuous clinical scoring systems (FLACC and COMFORT-B scale) and the NIPE.

Results: NIPE values, FLACC- and COMFORT-B scores were recorded in 17 infants with a mean age of 1.2 (range 0.8-5.9) months. NIPE values associated with positive FLACC- (≥ 4; indicative of pain) and/or COMFORT-B (≥ 17, indicative of discomfort) scores were lower (p < 0.001) than when associated with negative FLACC (< 4) and/or COMFORT-B (< 17) scores with 95% CI's of a difference of -14 to -11 (FLACC), -13 to -11 (COMFORT-B) and -14 to -11 (FLACC and COMFORT-B), with significant interindividual variability in NIPE values. Logistic regression analyses revealed odds ratios between 0.84 and 0.85; the adjacent receiver operating curve analyses showed areas under the curve between 0.83 and 0.88. NIPE data recording failure occurred during 49.3% of the periods with a FLACC ≥ 4% and 40.7% with a COMFORT-B ≥ 17.

Conclusions: The NIPE detects procedural pain and discomfort in conscious mechanically ventilated infants with an accuracy comparable to established clinical scoring systems. However, because of significant interindividual variability of NIPE values and frequent data recording failure associated with patient movement, we believe it is premature to recommend its use in conscious infants.

{"title":"The Newborn Infant Parasympathetic Evaluation Index for Assessment of Procedural Pain and Discomfort in Mechanically Ventilated Pediatric Intensive Care Patients: A Prospective, Exploratory, Observational Study.","authors":"Frank Weber, Emma Langen, Thomas Kerbusch, Eric Bokhorst","doi":"10.1111/pan.15050","DOIUrl":"https://doi.org/10.1111/pan.15050","url":null,"abstract":"<p><strong>Background: </strong>The heart rate variability-based Newborn Infant Parasympathetic Evaluation (NIPE) Index is a continuous noninvasive tool for the assessment of pain and discomfort in infants. Little is known about its performance in the pediatric intensive care unit (PICU) setting, where assessment of pain/discomfort is usually based on discontinuous observational scoring systems or personal experience of medical staff.</p><p><strong>Aim: </strong>Evaluation of the performance of NIPE as an indicator of procedural pain and/or discomfort in conscious mechanically ventilated PICU patients.</p><p><strong>Methods: </strong>Procedural pain/discomfort was simultaneously assessed during pain- or stressful procedures by two validated discontinuous clinical scoring systems (FLACC and COMFORT-B scale) and the NIPE.</p><p><strong>Results: </strong>NIPE values, FLACC- and COMFORT-B scores were recorded in 17 infants with a mean age of 1.2 (range 0.8-5.9) months. NIPE values associated with positive FLACC- (≥ 4; indicative of pain) and/or COMFORT-B (≥ 17, indicative of discomfort) scores were lower (p < 0.001) than when associated with negative FLACC (< 4) and/or COMFORT-B (< 17) scores with 95% CI's of a difference of -14 to -11 (FLACC), -13 to -11 (COMFORT-B) and -14 to -11 (FLACC and COMFORT-B), with significant interindividual variability in NIPE values. Logistic regression analyses revealed odds ratios between 0.84 and 0.85; the adjacent receiver operating curve analyses showed areas under the curve between 0.83 and 0.88. NIPE data recording failure occurred during 49.3% of the periods with a FLACC ≥ 4% and 40.7% with a COMFORT-B ≥ 17.</p><p><strong>Conclusions: </strong>The NIPE detects procedural pain and discomfort in conscious mechanically ventilated infants with an accuracy comparable to established clinical scoring systems. However, because of significant interindividual variability of NIPE values and frequent data recording failure associated with patient movement, we believe it is premature to recommend its use in conscious infants.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of Transgender and Gender-Diverse Topics Within Diversity, Equity, and Inclusion Curricular Content in Pediatric Anesthesiology Fellowship Programs in the United States and Canada-A Prospective Survey.
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-12-07 DOI: 10.1111/pan.15053
Merry E Krueger, Remigio A Roque, Travis L Reece-Nguyen, Hilary MacCormick
<p><strong>Background: </strong>Transgender and gender-diverse individuals experience higher burdens of health disparities compared to their cisgender counterparts. Contributing factors include decreased access and denial of care, experiences and fear of medical violence, and increasing legislative barriers. These patients often report having to educate healthcare professionals due to lack of expertise of transgender and gender-diverse issues within the medical community, with training deficits observed at all levels of medical training.</p><p><strong>Aims: </strong>We surveyed pediatric anesthesiology fellowship directors in the United States and Canada with an aim to describe the current state of transgender and gender-diverse topics within diversity, equity, and inclusion curricular content across pediatric anesthesiology fellowship training programs.</p><p><strong>Methods: </strong>A 25-question descriptive, cross-sectional, electronic survey was created and distributed to all pediatric anesthesiology fellowship program directors in the United States and Canada investigating the inclusion of transgender and gender-diverse topics within diversity, equity, and inclusion curriculum (if present) for pediatric anesthesiology fellows.</p><p><strong>Results: </strong>A total of 33 responses were collected from 69 total invited programs. Diversity, equity, and inclusion curricula were present in 93.5% (29/31) of fellowship programs but only 29% (9/31) of programs included content specific to transgender and gender-diverse populations. Just 17% (5/29) of program directors thought their curriculum adequately prepared their graduates to care for transgender and gender-diverse patients. However, 69% (20/29) expressed a desire to see more educational content included in the future. Lack of knowledgeable faculty educators and time were the most chosen perceived barriers to inclusion.</p><p><strong>Conclusions: </strong>To our knowledge, this study is the first to evaluate pediatric anesthesiology fellowship curricula for inclusion of transgender and gender-diverse topics within diversity, equity, and inclusion curriculum. As the population of known transgender and gender-diverse youth increases, all pediatric anesthesiologists must be equipped to treat this population with appropriate clinical and cultural sensitivity. Future endeavors must include robust sexual orientation and gender identity data collection, access to educational materials from content experts, recruitment and empowerment of LGBTQ+ anesthesiologists, and increased dedicated time toward diversity, equity, and inclusion education, specifically in regard to the transgender and gender-diverse population.</p><p><strong>Clinical implications: </strong>Lack of physician education on the care of transgender and gender-diverse patients is one of several factors contributing to the health disparities seen in this population; training deficits in the care of transgender and gender-diverse patients
{"title":"Analysis of Transgender and Gender-Diverse Topics Within Diversity, Equity, and Inclusion Curricular Content in Pediatric Anesthesiology Fellowship Programs in the United States and Canada-A Prospective Survey.","authors":"Merry E Krueger, Remigio A Roque, Travis L Reece-Nguyen, Hilary MacCormick","doi":"10.1111/pan.15053","DOIUrl":"https://doi.org/10.1111/pan.15053","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Transgender and gender-diverse individuals experience higher burdens of health disparities compared to their cisgender counterparts. Contributing factors include decreased access and denial of care, experiences and fear of medical violence, and increasing legislative barriers. These patients often report having to educate healthcare professionals due to lack of expertise of transgender and gender-diverse issues within the medical community, with training deficits observed at all levels of medical training.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;We surveyed pediatric anesthesiology fellowship directors in the United States and Canada with an aim to describe the current state of transgender and gender-diverse topics within diversity, equity, and inclusion curricular content across pediatric anesthesiology fellowship training programs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 25-question descriptive, cross-sectional, electronic survey was created and distributed to all pediatric anesthesiology fellowship program directors in the United States and Canada investigating the inclusion of transgender and gender-diverse topics within diversity, equity, and inclusion curriculum (if present) for pediatric anesthesiology fellows.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 33 responses were collected from 69 total invited programs. Diversity, equity, and inclusion curricula were present in 93.5% (29/31) of fellowship programs but only 29% (9/31) of programs included content specific to transgender and gender-diverse populations. Just 17% (5/29) of program directors thought their curriculum adequately prepared their graduates to care for transgender and gender-diverse patients. However, 69% (20/29) expressed a desire to see more educational content included in the future. Lack of knowledgeable faculty educators and time were the most chosen perceived barriers to inclusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;To our knowledge, this study is the first to evaluate pediatric anesthesiology fellowship curricula for inclusion of transgender and gender-diverse topics within diversity, equity, and inclusion curriculum. As the population of known transgender and gender-diverse youth increases, all pediatric anesthesiologists must be equipped to treat this population with appropriate clinical and cultural sensitivity. Future endeavors must include robust sexual orientation and gender identity data collection, access to educational materials from content experts, recruitment and empowerment of LGBTQ+ anesthesiologists, and increased dedicated time toward diversity, equity, and inclusion education, specifically in regard to the transgender and gender-diverse population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Lack of physician education on the care of transgender and gender-diverse patients is one of several factors contributing to the health disparities seen in this population; training deficits in the care of transgender and gender-diverse patients ","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Understanding Pediatric Anesthesiology Fellowship Interest: A National Survey of the Resident Experience.
IF 1.7 4区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-12-07 DOI: 10.1111/pan.15049
Philip Carullo, Sabina Khan, Rebecca Nause-Osthoff, Ruchika Gupta, James Xie, Razvan Azamfirei, Lieu Tran, Tammy Wang

Background: The field of pediatric anesthesiology faces an impending shortage of fellowship-trained physicians. Despite this projection, fewer anesthesiology residents are opting to pursue a fellowship. To better understand the current perspective and motivation of trainees to pursue a career in pediatric anesthesiology, we surveyed anesthesiology residents across the United States.

Aims: Our primary aims were to assess the understanding of the current workforce shortage as well as explore the impact of both exposure and characteristics of the anesthesia resident rotation on the decision to pursue pediatric anesthesiology fellowship.

Methods: A 25-question Qualtrics survey was distributed to members of the Pediatric Anesthesia Leadership Council and Education Committee within the Society for Pediatric Anesthesia and to anesthesiology residency program directors based in the United States.

Results: The survey received 201 responses. Of the respondents, 29% were in Clinical Anesthesia Year 3, 25% in Year 2, 19% in Year 1, and 10% in their intern year. The analysis revealed that self-reported adequate exposure to high-acuity cases and advanced procedures (arterial lines, central lines, and nerve blocks) significantly increased the likelihood of planning to pursue pediatric anesthesiology fellowship (adjusted Odd Ratio 8.47, 95% Confidence Interval, 1.65-43.4). Perceptions of faculty teaching, mentor availability, planned practice environment, and the presence of fellowship programs at the institution were not significantly associated with intentions to pursue pediatric anesthesiology fellowship.

Conclusions: The journey toward specializing in pediatric anesthesiology is influenced by a complex interplay of factors. Among these, enhanced exposure to challenging cases and advanced procedures during the residency phase is emerging as a critical element. Such exposure not only equips residents with the necessary skills and confidence to handle complex pediatric anesthesia cases but also plays a pivotal role in attracting more trainees to this essential subspecialty.

{"title":"Understanding Pediatric Anesthesiology Fellowship Interest: A National Survey of the Resident Experience.","authors":"Philip Carullo, Sabina Khan, Rebecca Nause-Osthoff, Ruchika Gupta, James Xie, Razvan Azamfirei, Lieu Tran, Tammy Wang","doi":"10.1111/pan.15049","DOIUrl":"https://doi.org/10.1111/pan.15049","url":null,"abstract":"<p><strong>Background: </strong>The field of pediatric anesthesiology faces an impending shortage of fellowship-trained physicians. Despite this projection, fewer anesthesiology residents are opting to pursue a fellowship. To better understand the current perspective and motivation of trainees to pursue a career in pediatric anesthesiology, we surveyed anesthesiology residents across the United States.</p><p><strong>Aims: </strong>Our primary aims were to assess the understanding of the current workforce shortage as well as explore the impact of both exposure and characteristics of the anesthesia resident rotation on the decision to pursue pediatric anesthesiology fellowship.</p><p><strong>Methods: </strong>A 25-question Qualtrics survey was distributed to members of the Pediatric Anesthesia Leadership Council and Education Committee within the Society for Pediatric Anesthesia and to anesthesiology residency program directors based in the United States.</p><p><strong>Results: </strong>The survey received 201 responses. Of the respondents, 29% were in Clinical Anesthesia Year 3, 25% in Year 2, 19% in Year 1, and 10% in their intern year. The analysis revealed that self-reported adequate exposure to high-acuity cases and advanced procedures (arterial lines, central lines, and nerve blocks) significantly increased the likelihood of planning to pursue pediatric anesthesiology fellowship (adjusted Odd Ratio 8.47, 95% Confidence Interval, 1.65-43.4). Perceptions of faculty teaching, mentor availability, planned practice environment, and the presence of fellowship programs at the institution were not significantly associated with intentions to pursue pediatric anesthesiology fellowship.</p><p><strong>Conclusions: </strong>The journey toward specializing in pediatric anesthesiology is influenced by a complex interplay of factors. Among these, enhanced exposure to challenging cases and advanced procedures during the residency phase is emerging as a critical element. Such exposure not only equips residents with the necessary skills and confidence to handle complex pediatric anesthesia cases but also plays a pivotal role in attracting more trainees to this essential subspecialty.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Pediatric Anesthesia
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