Page 10 - CASA Bulletin of Anesthesiology Vol 9 (4) 2022 (3)

CASA Bulletin of Anesthesiology

Neonatal procedures are being broadened. Dr. Zhang from Nanjing Children’s Hospital
wrote an article on anesthesia concerns on PDA procedures on extremely low birth weight
(ELBW) defined by birth weight less than 1500 grams, while Dr. Shi from Fudan University
affiliated Pediatric Hospital shared their expertise in new approaches on neonatal esophageal
atresia with airway deformity, or Tracheoesophageal Fistula (TEF).

One unique aspect of pediatric anesthesia is anxiety and separation from parents or
guardians, especially pre-school kids. Dr. Liang from Riley Children’s article shared the secret
weapon most Children’s Hospitals in the US have, the Certified Child life Specialists
(CCLS). At Indiana University, a CLS has a bachelor’s degree in this field, while Children’s
Health of Dallas requires a master's degree in this field due to popular demand in this job. Great
minds think alike, Drs. Jian and Liu from Fudan University affiliated Ear Nose Throat (ENT)
Hospital shared their routines to address pre-operative anxiety in pediatric patients coming for
ENT procedures.

Pediatric anesthesia is not complete without mention of management of congenital heart.
Dr. Bai from University of Michigan shared the clinical pearl of managing patients with Fontan
physiology for non-cardiac procedures. It is a great review article on the management of patients
with Fontan physiology and their relevant anesthesia concerns when they come for non-cardiac
surgery.

1. Visoiu M, Nubani L, Nicolay M. Continuous ultrasound-guided sacral intervertebral block for postoperative
analgesia in neonates. Pediatr Anaesth. 2022;32:82–84.
2. Alrayashi W, Berde C, Ultrasoundguided “saline myelogram”: Confirmation of intrathecal drug delivery despite
“dry tap” in infants for spinal anesthesia and spinal therapeutics. Pediatr Anesth. 2022;32:883–884.
3. Cho S-A, Kang P, Song I-S, et al. Performance time of anesthesiology trainees for cricothyroid membrane
identification and characteristics of cricothyroid membrane in pediatric patients using ultrasonography. Pediatr
Anesth. 2022;32:834–842.
4. Buis ML, Turner NM. New European Resuscitation Council guidelines for pediatric life support and their
implications for pediatric anesthesia: An educational article. Pediatr Anaesth. 2022;32:497–503.
5. Buis ML, Hogeveen M & Turner NM. The new European resuscitation council guidelines on newborn
resuscitation and support of the transition of infants at birth: An educational article. Pediatr Anaesth.
2022;32:504–508

儿科麻醉相当独特，同一天里，儿科麻醉医生可以从麻醉小于 800 克的早产儿到超过 300 磅
的高中足球后卫。与成人麻醉一样，超声在小儿麻醉管理中的作用越来越大。来自 UPMC 的
Visoiu 医生 分享了在超声引导下放置骶骨椎间导管于罹患骶部畸胎瘤和骶骨发育不全的两例个
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案报告，这些以前被认为是骶麻禁忌的。波士顿儿童医院的 Alrayashi 医生报告了超声引导的生
理盐水脊髓造影，以确认那些原本无脑脊液流出的腰部穿刺 。它具有减少用传统 X 光辅助操作
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的辐射暴露量的潜力。来自韩国的 Cho 博士 发表了 30 名住院医师使用超声检查识别环甲膜的
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所需时间以及儿科患者环甲膜的特征。虽然不是环甲膜的穿刺实际操作，但仅仅 30 分钟的视频

演示时间加上讲解后，100%的成功识别率和 28 秒的识别时间仍然令人印象深刻。
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