A5008769882- Pediatric Pain Management Techniques
- Anesthesia and Pain Management
- Musculoskeletal pain and rehabilitation
- Pain Mechanisms and Treatments
- Pain Management and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Anesthesia and Neurotoxicity Research
- Anesthesia and Sedative Agents
- Infant Development and Preterm Care
- Neurogenetic and Muscular Disorders Research
- Airway Management and Intubation Techniques
- Blood transfusion and management
- Spine and Intervertebral Disc Pathology
- Shoulder Injury and Treatment
- Intraocular Surgery and Lenses
- Childhood Cancer Survivors' Quality of Life
- Pain Management and Opioid Use
- Craniofacial Disorders and Treatments
- Sleep and related disorders
- Heart Rate Variability and Autonomic Control
- Congenital Anomalies and Fetal Surgery
- Neonatal Respiratory Health Research
- Nerve Injury and Rehabilitation
- Cardiovascular Syncope and Autonomic Disorders
- Epilepsy research and treatment
Harvard University
2016-2025
Boston Children's Hospital
2016-2025
Center for Pain and the Brain
2010-2023
Boston Children's Museum
2007-2022
Boston University
2010-2022
Smile Train
2022
Brigham and Women's Hospital
1993-2021
Research Network (United States)
2018
American Society of Anesthesiologists
2018
Children's Hospital of Philadelphia
2014
BackgroundIn laboratory animals, exposure to most general anaesthetics leads neurotoxicity manifested by neuronal cell death and abnormal behaviour cognition. Some large human cohort studies have shown an association between anaesthesia at a young age subsequent neurodevelopmental deficits, but these are prone bias. Others found no evidence for association. We aimed establish whether in early infancy affects outcomes.MethodsIn this international, assessor-masked, equivalence, randomised,...
The prevention of pain in neonates should be the goal all pediatricians and health care professionals who work with neonates, not only because it is ethical but also repeated painful exposures have potential for deleterious consequences. Neonates at greatest risk neurodevelopmental impairment as a result preterm birth (ie, smallest sickest) are those most likely to exposed number stimuli NICU. Although there major gaps knowledge regarding effective way prevent relieve proven safe therapies...
WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Complications in pediatric regional anesthesia are rare, so a large sample size is necessary to quantify risk. The Pediatric Regional Anesthesia Network contains data on more than 100,000 blocks administered at 20 children's hospitals. This study analyzed the risk of major complications associated with children.This prospective, observational routine clinical practice. Data were collected every block placed by an anesthesiologist...
Extensive blood loss is common in pediatric craniosynostosis reconstruction surgery. Tranexamic acid (TXA) increasingly used to reduce perioperative various settings, but data on its efficacy are limited children. The purpose of this randomized, double-blind, placebo-controlled, parallel trial was evaluate the TXA correction primary and secondary outcome variables were reduction transfusion, respectively.Forty-three children, ages 2 months 6 yr, received either placebo or a loading dose 50...
Nusinersen (ISIS-SMN Rx or ISIS 396443) is an antisense oligonucleotide drug administered intrathecally to treat spinal muscular atrophy. We summarize lumbar puncture experience in children with atrophy during a phase 1 open-label study of nusinersen and its extension. During the studies, 73 punctures were performed 28 patients 2 14 years age type 2/3 No complications occurred 50 (68%) punctures; 23 (32%) procedures, adverse events attributed puncture. Most common headache (n = 9), back pain...
Background Excessive bleeding often occurs during pediatric scoliosis surgery and is attributed to numerous factors, including accelerated fibrinolysis. The authors hypothesized that administration of tranexamic acid would reduce transfusion requirements surgery. Methods Forty-four patients scheduled undergo elective spinal fusion were randomly assigned receive either 100 mg/kg before incision followed by an infusion 10 mg . kg h (tranexamic group) or 0.9% saline (placebo group). General...
Sleep of good quantity and quality is considered a biologically important resource necessary to maintain homeostasis pain-regulatory processes. To assess the role chronic sleep disturbances in pain processing, we conducted laboratory testing subjects with primary insomnia. Seventeen participants insomnia (mean ± SEM 22.6 0.9 yrs, 11 women) were individually matched 17 healthy participants. All wore an actigraph device over 2-week period completed daily diaries. Laboratory was controlled...
Objectives: To examine clinical outcomes of an interdisciplinary day-hospital treatment program (comprised physical, occupational, and cognitive-behavioral therapies with medical nursing services) for pediatric complex regional pain syndrome (CRPS). Methods: The study is a longitudinal case series consecutive patients treated in rehabilitation program. Participants were 56 children adolescents ages 8 to 18 years (median=14 y) CRPS spectrum conditions who failed progress sufficiently previous...
In Brief Study Design. Retrospective review of intraoperative blood loss and replacement. Objective. We compared replacement during spinal fusion surgery for scoliosis in Duchenne muscular dystrophy (DMD) performed with without the synthetic antifibrinolytic agent tranexamic acid (TXA). Summary Background Data. High levels are widely documented DMD patients undergoing posterior scoliosis. The effect on decreasing has not been studied a large group patients. Methods. All 56 underwent same...
To describe the perioperative medical care, anesthetic considerations, and risk of postanesthetic respiratory failure in patients with pediatric spinal muscular atrophy (SMA).There is a retrospective chart review carried out at an urban, tertiary care hospital. All ICD-9 codes corresponding to SMA diagnoses were identified, records screened for management. Medical reviewed demographic, clinical, outcome data.Twenty-five children (10 type I, 8 II, 7 III) accounted 56 general regional cases....
Summary Opioids have long held a prominent role in the management of perioperative pain adults and children. Published reports concerning appropriate, inappropriate, use these medications pediatric patients appeared various publications over last 50 years. For this document, Society for Pediatric Anesthesia appointed taskforce to evaluate available literature formulate recommendations with respect most salient aspects opioid administration The are graded based on strength evidence, consensus...
Abstract Chronic pain conditions are highly comorbid with insufficient sleep. While the mechanistic relationships between 2 not understood, chronic sleep may be 1 pathway through which central pain-modulatory circuits deteriorate, thereby contributing to vulnerability over time. To test this hypothesis, an in-laboratory model of 3 weeks restricted limited recovery (5 nights 4-hour per night followed by 8-hour night) was compared (control protocol). Seventeen healthy adults participated, 14...
Summary Amygdala connectivity is altered in children with chronic neuropathic pain and responsive to intensive interdisciplinary treatment, an associated decrease pain-related fear. The amygdala a key brain region efferent afferent neural connections that involve complex behaviors such as pain, reward, fear, anxiety. This study evaluated resting state functional of the cortical subcortical regions group patients (pediatric regional syndrome) age-sex matched control subjects before after...
Background: Tranexamic acid (TXA) is an antifibrinolytic drug that reduces surgical blood loss. Evidence supporting its efficacy in surgery for adolescent idiopathic scoliosis not robust. This trial was designed to validate the clinical of TXA scoliosis. Methods: institutional review board-approved prospective double-blinded involved 111 patients with who were randomized receive either a placebo or (50-mg/kg loading dose and 10-mg/kg/h infusion). Power analysis indicated 50 per group would...