Week in review March 20-25

Myron Yaster MD

More on Chronic Post-Surgical Pain

Rita Agarwal MD and Myron Yaster MD

Original article

Thapa I, De Souza E, Ward A, Bambos N, Anderson TA. Association of Common Pediatric Surgeries With New Onset Chronic Pain in Patients 0-21 Years of Age in the United States. J Pain. 2023 Feb;24(2):320-331. PMID: 36216129

Original article

Dugan MQ, Delgado JR, De Souza E, Anderson TA.  Pediatric chronic post-surgical pain prevalence, pain scores, and quality-of-life: results of an exploratory patient survey at a single-center tertiary care children's hospital. J Anesth. 2022 Oct;36(5):606-611. PMID: 35829912

Chronic post surgical pain (CPSP) is defined as new onset pain at the surgical site that continues for more than 3 months.  Based on a survey with only a 4% response rate, the authors found that CPSP is more common in pediatric patients than previously thought.

Why is Fentanyl Different than other Mu agonist opioids?

Myron Yaster MD and Vidya Chidambaran MD, MS

Original article

Eamonn Kelly, Katy Sutcliffe, Damiana Cavallo, Nokomis Ramos-Gonzalez, Norah Alhosan, Graeme Henderson. The anomalous pharmacology of fentanyl. Br J Pharmacol. 2023 Apr;180(7):797-812. PMID: 34030211

Why is fentanyl so potent?  Why does it cause chest wall rigidity?  What properties make it so indispensable in anesthesia? Why is illicit fentanyl so lethal?  This basic science review provides some answers.

Artificial Intelligence and live interpretation of Ultrasound images

Hannah Lonsdale MBChB, Ali Hassanpour MD, and Julia Gálvez Delgado MD

Original article

 Bowness JS, El-Boghdadly K, Woodworth G, Noble JA, Higham H, Burckett-St Laurent D. Exploring the utility of assistive artificial intelligence for ultrasound scanning in regional anesthesia. Regional Anesthesia & Pain Medicine. 2022 Jun 1;47(6):375-9. PMID: 35091395

Today’s PAAD discusses a new device that is designed to assist in recognizing anatomic structures visualized with ultrasound for the planning of peripheral nerve blocks (PNBs) using articial intelligence (AI)

Consider the Opioid Crisis Again? Yes! Why? Because- “Repetitio est mater studiorum” (repetition is the mother of learning)

Alan Jay Schwartz, MD, MSEd and Bonnie L Milas, MD

Today’s guest authors describe “What is the role that all anesthesiologists must assume in developing solutions to the opioid crisis”?

Reader response

Myron Yaster MD

Alan J. Schwartz MD discusses the recent PAADs on rethinking and reimagining the pediatric anesthesia fellowship and offers a novel solution that was used in the past.  Dr. Jim DiNardo in discussing what makes fentanyl different than other opioids points out that fentanyl causes vocal cord closure (laryngospasm) in addition to chest wall rigidity. (A future PAAD will discuss this in greater detail.)  Drs. Anna Clebone and Priti Dalal announce that in the face of the brutal ongoing war in Ukraine, several Ukrainian pediatric anesthesiologists, Dr. Korsunov Volodymyr, MD,  Dr. Lyzogub Mykola, MD, Dr. Oleksandr Onikiienko, MD,PhD, and Dr. Pushkar Mykhailo, MD, PhD have completed a Ukrainian translation of the pedi crisis checklists which have just been published on SPA’s website.  All we can say is WOW and “Sláva Ukrayíni!” "Glory to Ukraine!"