Pediatric Anesthesiology 2003

Course Objectives

Sleep Apnea Physiologic and Clinical Correlates

Sleep Studies Interpretation and Implications Upon completion of this lecture, the participant will be able to describe how sleep studies are performed and analyzed in children. The participant will understand the relationship between abnormalities in sleep studies and clinical symptoms in children.

Alterations in Upper Airway Anatomy and Physiology in Children with Sleep Apnea Upon completion of this lecture, the participant will know how upper airway patency is altered in children with sleep apnea including the effect of common airway maneuvers on airway patency.

Anesthetic/Sedative Effects on Upper Airway Patency Upon completion of this lecture the participant will understand the effects of anesthetics and sedatives on upper airway patency in normal children under circumstance which parallel normal anesthetic/sedation management.

Effects of Anesthetics on Control of Ventilation
Upon completion of this lecture, the participant will be able to discuss the effects of anesthetic agents on the control of ventilation in children.

Anesthetic Management of the Patient with (or at risk for) Apnea Upon completion of this lecture, the participant will be able to discuss advantages and disadvantages of various agents and drugs for anesthetic induction/maintenance and analgesia of infants and children with sleep apnea or at risk for postoperative apnea.

Spine Surgery the Big Picture

Neurophysiologic Monitoring Upon completion of this lecture, the participant will be able to discuss the various modalities of brain and spinal cord monitoring and their utility in safeguarding the neurologic integrity of children undergoing spine surgery. The participant will learn about current knowledge of the effects of various factors, including anesthetic agents and neuromuscular blocking drugs on the validity of neurophysiologic monitoring.

New Surgical Techniques in Spine Surgery Upon completion of this lecture, the participant will be able to discuss surgical techniques in spine surgery including newer thoracoscopic and other non-invasive techniques and combined anterior-posterior procedures and their implications for this anesthesiologist.

Blood Loss in Spine Surgery: Monitoring, Conservation, and Replacement
Upon completion of this lecture, the participant will be able to discuss methods of monitoring blood loss and current thinking on blood conservation and replacement strategies.

PRO/CON: Postoperative Analgesia for Spine Surgery
Epidural/Spinal Upon completion of this lecture, the participant will be able to discuss the techniques, efficacy, and complications of epidural and spinal modes of analgesia which may be used in the postoperative spine surgery patient.

IVPCA/?NSAIDS/Adjuvants Upon completion of this lecture, the participant will be able to discuss the use of intravenous opioid patient-controlled analgesia in postoperative spine surgery patients. The participant will learn about efficacy and side effects and the use of adjuvant agents to improved analgesia and reduce side effects. The participant will understand the controversies regarding the use of NSAIDS in the spine surgery patient.

BAXTER BREAKFAST

Sedation for Painful Procedures in Children - Who, What, When, How Upon completion of this lecture, the participant will be able to discuss controversies in the provision of sedation/analgesia for painful procedures to children. How JCAHO mandates affect the responsibility of anesthesiologists with respect to sedation? What are best practices for personnel, monitoring, drug selection, and recovery? Who pays?

AAP Lecture — Medical Care for Children in Foster Care: A Pediatrician's Personal Odyssey
Following this lecture, the participant will have an understanding of the dynamic relationship between social service and medical care of these children, including the positive/negative impacts that foster care has on children.

Legal Issues and the Anesthesiologist

The Growing Malpractice Crisis Insurance Issues for Anesthesiologists Upon completion of this lecture, the participant will be to discuss the current state of the insurance industry and the origin of the malpractice insurance availability crisis and what options are available for dealing with it. How decrease in availability/increased cost of surgical malpractice insurance is affecting anesthesiologists.

Loss Prevention and Liability Issues Upon completion of this lecture, the participant will be able to discuss current trends in anesthesia malpractice claims and strategies for decreasing liability without compromising care.

Refresher Courses

Neonatal Pain Management — Recent advances in pain management in neonates, including epidural analgesia. Monitoring and adverse effects of pain management in neonates

Update on Latex Allergy — Incidence and prevalence of latex allergy in pediatric surgical patients and health care personnel. Recognition and treatment of intraoperative latex anaphylaxis. Creating a latex free operating room environment.

Anesthetic Management of Children with Cerebral Palsy — Review pathophysiology of neuromuscular dysfunction with cerebral palsy. Review preoperative evaluation of children with cerebral palsy. Review strategies for intra- and postoperative management of children with cerebral palsy.

Update in Pediatric Cardiac Anesthesia — Review management of anesthesia for pediatric cardiac surgical procedures. Discuss advances in preoperative, intraoperative and postoperative care of infants and children with congenital heart disease. Discuss advances in management of cardiopulmonary bypass, intravascular volume, and coagulation

Anesthesia for Neonatal Surgical Emergencies — Review conditions which require surgery in the neonatal period. Review physiologic and pharmacologic considerations important in anesthetic management of emergency surgery in the neonate

Analgesic Administration Alternative Modes of Delivery — Review recent advances in alternative modes of delivery of analgesics. Discuss efficacy of various analgesic strategies in children. Future directions in analgesic drug delivery

Pain Assessment and Management in the Cognitively Impaired Child — Review methods of pain assessment in children. Discuss pain scales developed for use in children with cognitive impairment. Pain management strategies for children with cognitive impairment.

Anesthesia for Airway Surgery — Review common conditions requiring airway surgery in children; Discuss concerns of the "shared airway" and Anesthetic techniques of choice for airway surgery: which to choose

Workshops

Acupuncture — Upon completion of this workshop, the attendee will understand the indications, uses, limitations, theory, and basic techniques of acupuncture as applied to pediatric patients.

Airway — Upon completion of this workshop, the participant will be familiar with advanced airway management techniques, including Bullard laryngoscope, lighted stylette, fiberoptic bronchoscope, airway camera, and emergency tracheostomy.

CPR and Intraosseous Access — Upon completion of this workshop, the attendee will be familiar with most recent recommendations for pediatric cardiopulmonary resuscitation including drug therapy and management of ventilation including application in the operative setting. Techniques and utility of intraosseous infusion will be discussed.

Clinical Trial Designs — The participant will review the essential components in design and execution of clinical trials. Describe the resources available to support clinical research endeavors.

Magical Distractions for Children — Upon completion of this lecture, the participant will be to demonstrate magic illusions that can be employed to distract children (or surgeons) during induction of anesthesia and discuss the benefits of magic and other distractions to alternatives such as premedication.

Managing Epidurals— Caudal to Thoracic: Intra and Postoperative Management
Upon completion of this lecture, the participant will be able to explain the caudal to cervical approach, single-shot techniques, catheter placement and confirmation, monitoring, problem-solving and patient selection.

Common Nerve Blocks: when and how to use them Upon completion of this workshop, the attendee will understand the anatomy, techniques (including equipment and drug selection), application and potential complications of the most commonly utilized peripheral nerve blocks in children. Blocks discussed will include axillary, femoral, fascia iliaca, sciatic, ankle, and penile nerve blocks.

Population Pharmacokinetic Drug Trials in Children Upon completion of this workshop, the participant will be familiar with the concepts of population pharmacokinetic drug trials. Discussion will include principles of population pharmacokinetics, recent FDA requirements for drug evaluation in children, and issues of consent for research in children.

Spinal Anesthesia Upon completion of this workshop, the participant will be familiar with anatomical approaches, equipment, drug selection, indications, and complications of spinal anesthesia in children and infants.

What's New for Acute Pain Upon completion of this workshop, the participant will be familiar with recent advances in management of acute pain in children, including adjuvants and non-pharmacologic techniques.

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