Spring 2015 Update

By David M. Polaner, MD, FAAP
Children's Hospital Colorado
Aurora, CO

The Pediatric Regional Anesthesia Network (PRAN) now has over 86,000 cases in the database (Figure 1). We now have 20 centers in the network, and are adding approximately 1500- 2000 cases per month (Table 1). We continue to be interested in recruiting new centers to the Network. Joining PRAN has only four requirements:

    1. A commitment to enter every regional block at your institution and to enter detailed data on every complication identified
    2. A commitment to complete monthly audits using the PRAN audit module (audits cover about 10% of blocks and 100% of complications)
    3. Approval from your institution’s IRB
    4. An annual fee to help fund web site and database maintenance

Members of PRAN are participating investigators in all of the studies to come out of the Network, have access to both their institutional data as well as the de-identified aggregate data for your own benchmarking and QI purposes, and can propose, develop and carry out novel studies that use the entire data repository.

We continue to have new manuscripts published and have previously published those frequently cited (Table 2).  The paper on “awake versus asleep” was a particularly important landmark, as it provided the very first prospective data in the literature on this highly controversial issue. As the numbers in the database increase we expect that we will be able to learn more about less common events.

One more paper has been provisionally accepted to BJA (BJ Walker, JB Long, GS De Oliveira Jr, P Szmuk, C Setiawan, DM Polaner, S Suresh  and the PRAN Investigators. Peripheral Nerve Catheters in Children: An Analysis of Safety and Practice Patterns from the Pediatric Regional Anesthesia Network (PRAN)), and several others are in preparation.

Representatives from PRAN and ASRA (Suresh, Polaner, Krane, Bosenberg, Neal) have been working with our European counterparts from ESRA (Ivani (Italy), Veyckemans (Belgium), Lonnqvist (Sweden), Ecoffey (France), Van de Velde (Belgium)) in formulating a set of guidelines and critical reviews of major controversial or unsettled issues in pediatric regional anesthesia. This will be published in RAPM this spring. We anticipate that this will be the first of future collaborations with our counterparts in Europe, and will develop processes for consensus on both best practice and ongoing studies on regional anesthesia in pediatrics.

The revision of the PRAN database is well underway, and it is slated to come on line this spring or summer. The database and website are being upgraded to improve usability and add to or enhance the data elements currently being collected; migration to the new server will occur in the next month. Axio Research continues to be our generous and critical partner in this endeavor.

Perhaps the most important organizational news from PRAN is the “retirement” of our founding co-chair, Lynn Martin, who has decided to step down due to his new position at Seattle Children’s, which will not afford him the ability to continue the same degree of engagement on the clinical research side. Lynn and I came up with the idea of PRAN 10 years ago, and I will especially miss his terrific leadership and wise counsel.

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