A5067272476- Anesthesia and Pain Management
- Cardiac, Anesthesia and Surgical Outcomes
- Pediatric Pain Management Techniques
- Shoulder Injury and Treatment
- Enhanced Recovery After Surgery
- Airway Management and Intubation Techniques
- Nausea and vomiting management
- Scoliosis diagnosis and treatment
- Pectus Deformity Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Traumatic Ocular and Foreign Body Injuries
- Knee injuries and reconstruction techniques
- Craniofacial Disorders and Treatments
- Anesthesia and Sedative Agents
- Surgical Simulation and Training
- Family and Patient Care in Intensive Care Units
- Cleft Lip and Palate Research
- Intraoperative Neuromonitoring and Anesthetic Effects
- Hemodynamic Monitoring and Therapy
- Head and Neck Surgical Oncology
- Infant Development and Preterm Care
- Ultrasound in Clinical Applications
- Delphi Technique in Research
- Hospital Admissions and Outcomes
- Simulation-Based Education in Healthcare
Children's Hospital of Philadelphia
2016-2025
University of Pennsylvania
2016-2025
Society for Pediatric Anesthesia
2020
Drexel University
2016
Philadelphia University
2013-2014
University of Pittsburgh
2011
Consumer Healthcare Products Association
2011
University of Mary Washington
2011
BACKGROUND: Posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) is associated with significant pain and prolonged hospitalization. There evidence that early mobilization multimodal analgesia can accelerate functional recovery reduced length of stay (LOS). Using these principles, we implemented a quality improvement initiative to enable earlier in our AIS–PSF population. METHODS: We designed standardized rapid pathway (RRP) evidence-based management recommendations...
Bilateral myringotomy and pressure equalization tube insertion (BMT) is the most common surgery in children. Multiple anesthetic techniques for BMT have been proposed, but that which reliably promotes ideal recovery remains unclear. We sought to assess associations between regimens included single-agent (fentanyl or ketorolac) dual-agent analgesic therapy primary outcome of maximal postanesthesia care unit (PACU) pain score. Secondary outcomes in-hospital rescue administration, time, emesis...
Although the role of regional anesthesia in pediatric patients has been increasing over last few years, there are only a small case series that describe use ambulatory continuous peripheral nerve blocks (CPNBs) this patient population. In report, we our experience with CPNBs 1285 children.Data were collected for consecutive children who had CPNB placed between January 2005 and December 2011 at The Children's Hospital Philadelphia from departmental database. Data included demographics, site...
Background Children are required to fast before elective general anesthesia. This study hypothesized that prolonged fasting causes volume depletion manifests as low blood pressure. aimed assess the association between fluid duration and postinduction Methods A retrospective cohort was performed of 15,543 anesthetized children without preinduction venous access who underwent surgery from 2016 2017 at Children’s Hospital Philadelphia. Low pressure defined systolic lower than 2 standard...
BACKGROUND: Acute orthopedic injuries and subsequent surgical repair can be challenging for children adolescents result in posttraumatic stress reactions that problematic after the acute perioperative period. In a cohort of patients undergoing anterior cruciate ligament reconstruction (ACLR), we investigated incidence explored risk factors associated with development disorder (PTSD) symptoms surgery. METHODS: We analyzed data from multicenter, prospective, observational registry pediatric...
Pectus excavatum is the most common congenital chest wall deformity. The Nuss procedure frequently used for surgical correction and this technique has been associated with severe prolonged post-operative pain. At present time, optimal analgesic strategy managing patients following not determined.A web-based survey was sent to representatives from 108 primarily pediatric hospitals in North America, Europe, Asia Australia. One individual per institution contacted complete on behalf of their...
As high-quality health care becomes increasingly expensive, improvement projects are focused on reducing cost and increasing value. To increase value by operating room (OR) utilization, we studied the effect of a dedicated team approach for posterior spinal fusion (PSF) scoliosis.With institutional support, an interdisciplinary, was assembled. Members developed standardized protocols anesthetic management patient transport, positioning, preparation, draping, imaging, wake-up. These were...
Background: Cleft repair requires multiple operations from infancy through adolescence, with repeated exposure to opioids and their associated risks. The authors implemented a quality improvement project reduce perioperative opioid in cleft lip/palate population. Methods: After identifying key drivers of administration, interventions were developed address these postoperative administration 0.30 mg/kg morphine equivalents 0.20 equivalents. Data retrospectively collected January 1, 2015,...
Although 200 000 adolescents undergo anterior cruciate ligament reconstruction (ACLR) surgery annually, no benchmarks for pediatric post-ACLR pain management exist. We created a multicenter, prospective, observational registry to describe practices, pain, and functional recovery after ACLR.
BACKGROUND: There are few comparative data on the analgesic options used to manage patients undergoing minimally invasive repair of pectus excavatum (MIRPE). The Society for Pediatric Anesthesia Improvement Network was established investigate outcomes procedures where there is significant management variability. For our first study, we a multicenter observational database characterize strategies pediatric MIRPE. Outcome from participating centers were assess association between strategy and...
Summary Background Pain management following minimally invasive repair of pectus excavatum is variable. We recently adopted a comprehensive multimodal analgesic protocol that standardizes perioperative management. hypothesized patients managed with this would use more opioids postoperatively, have similar pain control, and shorter length stay compared to thoracic epidural infusion. Aims retrospectively opioid consumption, scores, between cohort our Methods This retrospective comparison...
Background Our aim in this observational study was to utilize ultrasound, as well anatomic dissection, document the frequency with which branches of subclavian vessels are found close association brachial plexus at locations supraclavicular and interscalene block. Methods Ultrasound utilized presence vein artery, adjacent region 50 patients undergoing shoulder surgery. The position, depth, dimensions were described, origin determined when possible. In addition, posterior triangle neck on...
Background: Postoperative nausea and vomiting (PONV) affects patient satisfaction, health care costs, hospital stay by complicating the postoperative recovery period after adolescent idiopathic scoliosis (AIS) spinal fusion surgery. Our goal was to identify recommendations for optimal management of PONV in AIS patients undergoing posterior (PSF). Methods: We performed a systematic review June 2022, searching PubMed Embase electronic databases using search terms “(Adolescent scoliosis) AND...
Adolescent Idiopathic Scoliosis (AIS) affects 2%-4% of the general pediatric population. While surgical correction remains one most common orthopedic procedures performed in pediatrics, limited consensus exists on perioperative anesthetic management.
BACKGROUND AND OBJECTIVES Cefazolin, a first-generation cephalosporin, is the most commonly recommended antibiotic for perioperative prophylaxis to reduce surgical site infections. Children with reported penicillin allergy often receive an alternative because of common misunderstanding cross-reactivity between these antibiotics. This use antibiotics in populations have been associated increased infections, resistance, and health care costs. We aimed increase percentage patients nonsevere...
Summary Introduction Continuous thoracic epidural analgesia is useful in the management of infants following thoracotomy. Concerns about drug accumulation and toxicity limit amount amide local anesthetics that can be delivered. infusions ester anesthetic chloroprocaine result little allowing for higher infusion rates. We retrospectively compared patients managed with 1.5% 2‐ or 0.1% ropivacaine to determine if increased rate resulted similar improved analgesia. Methods This retrospective...
Inhalational anesthetic agents are potent greenhouse gases with global warming potential that far exceed of carbon dioxide. Traditionally, pediatric inhalation inductions achieved a volatile delivered to the patient in oxygen and nitrous oxide at high fresh gas flows. While contemporary anesthetics anesthesia machines allow for more environmentally conscious induction, practice has not changed. We aimed reduce environmental impact our by decreasing use flows.Through series four...
Adequate pain control and early mobilization are critical in the postoperative period after periacetabular osteotomy (PAO). Regional anesthesia can reduce pain, but certain techniques increase risk of motor block delayed functional recovery. Continuous lumbar epidurals provide excellent analgesia also create challenges with ambulation. Recently, suprainguinal fascia iliaca (SIFI) single-shot blocks have been shown to effective PAO patients. The goal this study was compare opioid use, time...