Pediatric Anesthesia最新文献

{"title":"The Electronic Faces Thermometer Scale (eFTS)-Construct Validity for Pain Assessment in Pediatric Postoperative Care in Sweden.","authors":"Angelica Höök, Mia Hylén, Maria Björk, Stefan Nilsson, Jinbing Bai, Henrik Berlin, Helena Hansson, Gudrún Kristjánsdóttir, Rikard Roxner, Pernilla Stenström, Charlotte Castor","doi":"10.1111/pan.70056","DOIUrl":"https://doi.org/10.1111/pan.70056","url":null,"abstract":"<p><strong>Background: </strong>Pain in children is undertreated. An assessment scale co-designed with children, parents, and health care professionals could lead to more effective pain assessments and treatment strategies aimed at reducing pain and pain-related symptoms. There are analogue scales validated for self-report of pain in children, but today, children regularly use digital technology, which healthcare should align with. The newly developed electronic Faces Thermometer Scale is a digital assessment scale that needs further validation before it may be recommended for self-reporting pain intensity.</p><p><strong>Aims: </strong>The study aimed to determine the convergent and discriminant validity of a new digital pain assessment scale in a pediatric postoperative setting.</p><p><strong>Methods: </strong>The study was performed at a pediatric surgery department in southern Sweden. A total of 88 children were included, generating 716 assessments. Convergent validity was established by comparing the well-validated Colored Analogue Scale and Faces Pain Scale Revised with the electronic Faces Thermometer Scale. Pain assessments were conducted at three different time points: one before surgery, one once the participant became alert and aware, and one 30-45 min after the second time point. A p-value of 0.05 was considered statistically significant. Discriminant validity was established by comparing a potential non-painful situation with a painful situation using the electronic Faces Thermometer Scale.</p><p><strong>Results: </strong>The agreement between the scales at different time points, as well as across different ages and gender, showed a statistically significant correlation: Kendall's Tau B correlation coefficient varied between 0.61 and 0.79 at different time points. The electronic Faces Thermometer Scale was able to discriminate pain across different age groups and genders. There was a statistically significant difference between pre- and postoperative assessments, and the Clopper-Pearson proportion ranged from 0.70 to 0.90.</p><p><strong>Conclusions: </strong>The electronic Faces Thermometer Scale provides a valid digital scale for self-report of pain within pediatric postoperative care.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113527","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}

{"title":"Augmented Reality Medical Simulation: A Multi-Site Study of Factors That Influence Acceptance.","authors":"Ellen Y Wang, Samuel Castro, Lijin Zhang, Man Yee Suen, Marc Parris, Asher Marks, Veronica Weser, Anthony B Longhini, Kimberly M Strupp, Michael R Hernandez, Justin S Libaw, Sophie Kupiec-Weglinski, Thomas J Lockhart, Vanessa A Olbrecht, Lydia Lai-Ning Lau, Thomas J Caruso","doi":"10.1111/pan.70057","DOIUrl":"https://doi.org/10.1111/pan.70057","url":null,"abstract":"<p><strong>Background: </strong>The infrequent occurrence of resuscitating critically ill pediatric patients poses educational challenges for pediatric anesthesiology residents developing competence. Traditional medical simulations, despite their utility, incur significant costs due to the need for monitors, mannequins, and personnel. Augmented reality (AR) medical simulation shows promise as an alternative clinical teaching tool. The Technology Acceptance Model (TAM) assesses usefulness, ease of use, and attitudes toward new technologies, offering insights into their adoption. Following successful application with other healthcare innovations, the TAM can also assess innovations in pediatric anesthesiology resident education, including AR medical simulation.</p><p><strong>Aims: </strong>The primary aim identified factors that influenced acceptance of AR for medical simulation in pediatric anesthesiology using a TAM. The secondary aims assessed the model's reliability, usability, and ergonomics.</p><p><strong>Methods: </strong>This prospective, multi-site study was carried out across nine academic children's hospitals around the United States and Hong Kong. We recruited anesthesiology residents with a minimum of two weeks of pediatric anesthesia experience, excluding those with severe motion sickness, seizures, or who wore corrective glasses. Using Magic Leap 1 headsets, participants underwent a simulated AR pediatric resuscitation scenario. Data were collected via electronic surveys, evaluating TAM factors, usability (System Usability Scale), and ergonomics (ISO 9241-400 standard).</p><p><strong>Results: </strong>A total of 101 participants completed the study. The AR TAM model indicated that perceived ease of use and computer self-efficacy predicted perceived usefulness. Behavioral intention to use the AR system was influenced by perceived usefulness and perceived ease of use. System usability scores showed 83% agreement on ease of use. Ergonomic assessments indicated minimal physical discomfort.</p><p><strong>Conclusion: </strong>AR simulations are highly acceptable and usable for pediatric resuscitation training, with perceived ease of use and computer self-efficacy influencing AR adoption. These findings align with previous TAM studies, supporting AR's potential to supplement traditional simulations and enhance accessibility.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081214","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}

{"title":"Estimation of Residual Gastric Content After 3 or 4 h Fasting for Breast Milk in Infants: A Pilot Study With Randomization.","authors":"Sára Morell, Ahmed Uslu, Ali-Reza Modiri, Hanna Andersson, Peter Frykholm","doi":"10.1111/pan.70053","DOIUrl":"https://doi.org/10.1111/pan.70053","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075913","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}

{"title":"Error Traps in Pediatric Total Intravenous Anesthesia Knowledge Gaps and a Practical Perspective.","authors":"Lucas Guimarães Ferreira Fonseca, Adam Keys, Matthew Hart, Justin Skowno","doi":"10.1111/pan.70051","DOIUrl":"https://doi.org/10.1111/pan.70051","url":null,"abstract":"<p><p>Pediatric total intravenous anesthesia (TIVA) with propofol is well-established, safe, and offers advantages over volatile anesthesia. Nevertheless, its use remains limited because of inadequate training and knowledge, lack of confidence, perceived complexity, and uncertainty or limited awareness of its benefits. This error traps article explores key principles for the safe and effective use of pediatric TIVA, including pharmacological principles, the role of adjunct agents, practical aspects of drug delivery, electroencephalography-based monitoring, and the use of TIVA in specific populations.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070125","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}

{"title":"Brachial Plexus Block Reduces Pain Scores During Peripherally Inserted Central Catheter Placement in Neonates and Pediatric Patients Compared to Local Infiltration Anesthesia: A Randomized, Double-Blind, Single-Center Study.","authors":"Wataru Sakai, Tomohiro Chaki, Takeshi Murouchi, Yuki Ichisaka, Yuko Nawa, Tomohiro Nawa, Michiaki Yamakage","doi":"10.1111/pan.70055","DOIUrl":"https://doi.org/10.1111/pan.70055","url":null,"abstract":"<p><strong>Background: </strong>Effective pain management during peripherally inserted central catheter placement in neonates and pediatric patients remains challenging, often leading to procedural distress and suboptimal outcomes.</p><p><strong>Aim: </strong>This randomized controlled trial aimed to evaluate the analgesic efficacy of brachial plexus block compared to local infiltration anesthesia during peripherally inserted central catheter placement.</p><p><strong>Methods: </strong>Seventy patients were randomized into two groups: brachial plexus block (Group B) and local infiltration anesthesia (Group C). Procedural pain was assessed using the Comfort Neo Scale at T = 0 min (puncture) and T = 30 min (30 min after the procedure). Secondary outcomes included the first-attempt success rate, procedure time, number of puncture attempts, and rescue analgesic use. All interventions were performed under ultrasonographic guidance. Continuous data are expressed as medians [interquartile range (IQR)].</p><p><strong>Results: </strong>The median Comfort Neo Scale scores at T = 0 were significantly lower in Group B (6 [6-6]) than in Group C (30 [30-30]; difference: -24, 95% CI: -24 to -24, p < 0.0001). At T = 30, the scores remained lower in Group B (6 [6-6]) than in Group C (22 [12-30]; difference: -16, 95% CI: -19 to -10, p < 0.0001). Group B also demonstrated shorter procedure times (30 [20-30] vs. 40 [30-50] min; difference: -10 min, 95% CI: -20 to -10, p < 0.0001), higher first-attempt success rates (61% vs. 38%; odds ratio: 0.08, 95% CI: 0.03-0.26, p < 0.0001), and fewer puncture attempts (1 [1-2] vs. 2 [1-3]; difference: -1, 95% CI: -2 to 0, p < 0.001). Rescue analgesic use and pain-related movements were significantly reduced in Group B (odds ratio for pain-related movement: ∞, 95% CI: 109-∞, p < 0.0001).</p><p><strong>Conclusions: </strong>Brachial plexus block provides superior pain relief and procedural outcomes compared to local infiltration anesthesia during peripherally inserted central catheter placement in neonates and pediatric patients. Its adoption as a standard pain management approach can enhance patient comfort, improve efficiency, and reduce procedural distress. Future studies should explore the broad applicability and long-term benefits of this approach.</p><p><strong>Trial registration: </strong>Japan Registry of Clinical Trials (jRCT): jRCT1010220045.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070111","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}

{"title":"Unanticipated Admission in Pediatric Cerebral Palsy: Hidden Confounders and the Importance of Risk Stratification.","authors":"Joyce Lee, Cassandra Duncan-Azadi, Amir Butt, Aimee Pak","doi":"10.1111/pan.70054","DOIUrl":"https://doi.org/10.1111/pan.70054","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065311","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}

{"title":"Current Practices in the Management of Surgical Pediatric Patients With Do-Not-Attempt-Resuscitation (DNAR) Directives.","authors":"Camryn Thompson, Kathleen A Young, Thomas Clark Howell, Elizabeth B Malinzak, Brad M Taicher, Ryan M Antiel","doi":"10.1111/pan.70049","DOIUrl":"https://doi.org/10.1111/pan.70049","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054979","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}

{"title":"Detection of Nociceptive Stimuli Using the Newborn Infant Parasympathetic Evaluation Index in Children Aged From 3 to 18 Years.","authors":"Frantisek Kolek, Jakub Jonas, Tomas Vymazal","doi":"10.1111/pan.15129","DOIUrl":"10.1111/pan.15129","url":null,"abstract":"<p><strong>Background: </strong>One option to objectively monitor patient stress response is to measure parasympathetic nervous system tone using respiratory arrhythmia analysis. The Newborn Infant Parasympathetic Evaluation (NIPE) Index has been developed for children younger than 2 years of age, and reliability has been confirmed by several studies.</p><p><strong>Aims: </strong>The aim of this study is to determine whether this method is also applicable to older children.</p><p><strong>Methods: </strong>Patients aged 3-18 years, admitted to the Department of Anaesthesiology and Intensive Care Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, were included in this study. NIPE monitoring was provided on patients with airways secured by endotracheal intubation or tracheostomy. NIPE values were recorded before endotracheal suctioning, 1 min after the start, and 5 min after the end of suctioning. Subsequently, the averages of the values were analyzed using ANOVA and the Scheffé test. Along with the NIPE value, changes in hemodynamic parameters were monitored during the suction, and the results of both methods were compared.</p><p><strong>Results: </strong>The NIPE value during endotracheal suctioning was significantly lower, with an average reduction of 13.4 points on a 100-point scale, and returned to baseline 5 min after suctioning ended. No significant changes in hemodynamic parameters (heart rate and blood pressure) were observed, either in the whole group of patients or in the group not receiving catecholamine support.</p><p><strong>Conclusions: </strong>The NIPE index detects the stress response to endotracheal suctioning in children older than 3 years and is more sensitive than hemodynamic parameters, regardless of catecholamine therapy.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"747-752"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Modified Fasting Protocols to Shorten Fasting Time Before Sedation in Children: A Prospective Randomized Noninferiority Trial.","authors":"Eunah Cho, Jinyoung Song, June Huh, I-Seok Kang, Hyun Ju Kim, In Young Youn, Hyebin Lee, Ji Hee Kwak","doi":"10.1111/pan.15142","DOIUrl":"10.1111/pan.15142","url":null,"abstract":"<p><strong>Backgrounds: </strong>Guidelines for fasting before procedural sedation aim to prevent pulmonary aspiration and are primarily targeted for deep sedation. Our study explored whether a shortened fasting protocol is noninferior to the standard protocol by comparing gastric contents evaluated by ultrasound.</p><p><strong>Methods: </strong>Pediatric patients aged < 3 years, scheduled for elective transthoracic echocardiography under sedation, were randomly allocated to a standard group (4-h fasting) or a modified group (4-h fasting for solid and 1-h fasting for water). Gastric ultrasound was performed to evaluate cross-sectional area (CSA) in supine and right lateral decubitus positions (RLDP), with the upper body elevated at 45°. The primary outcome was the CSA-RLDP (CSA_{RLDP 45}). A noninferiority test was performed applying the delta (Δ) of 2.1.</p><p><strong>Results: </strong>The noninferiority test showed that the modified fasting protocol was noninferior to the standard fasting protocol in terms of CSA_{RLDP 45}, with a mean difference (95% confidence interval) of 0.16 (-0.55 to 0.87) within the noninferiority range of delta.</p><p><strong>Conclusion: </strong>The modified fasting protocol was noninferior to the standard in pediatric patients undergoing sedation for transthoracic echocardiography, as assessed by gastric ultrasound.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05810532.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"753-760"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing Generative Artificial Intelligence in Pediatric Anesthesia: Enhancing Learning, Patient Care, and Family Communication.","authors":"Asad Siddiqui, Vikas N O'Reilly-Shah, Allan F Simpao, Hannah Lonsdale","doi":"10.1111/pan.70005","DOIUrl":"10.1111/pan.70005","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"691-694"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}