Paediatric anaesthesia
Audio Summaries

Effects of Esketamine on Emergence Delirium in Children Undergoing Sevoflurane Anesthesia: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis

Aug 6, 2026

This systematic review and meta-analysis aimed to evaluate the efficacy and safety of esketamine in preventing emergence delirium in children undergoing sevoflurane anesthesia. The findings indicate that esketamine significantly reduces the incidence of emergence delirium and postoperative pain, while also decreasing postoperative nausea and vomiting, although it is associated with a modest increase in extubation time. Overall, the evidence suggests that esketamine is a promising option for improving postoperative outcomes in pediatric patients.

A Retrospective Study on Time Impact of Major Trauma Patients Requiring Access to the Operating Room on the Anesthesia Department of a Pediatric Trauma Center

Aug 6, 2026

The authors aimed to analyze the characteristics and surgical access patterns of pediatric major trauma patients at The Hospital for Sick Children, focusing on the impact on the anesthesia department. They found that 19.6% of trauma patients required surgery, with varying access times to the operating room, and identified a correlation between the number of surgical procedures and length of hospital stay. The study highlights the significant resource demands of major trauma cases and suggests the need for further research to optimize intra-hospital flow and resource utilization.

Evaluating the Impact of Clonidine and Midazolam Premedication on Emergence Delirium in Pediatric Patients

Aug 1, 2026

This study aimed to evaluate the impact of premedication with clonidine or midazolam on the incidence of emergence delirium in pediatric patients undergoing general anesthesia. The analysis of data from 4,796 anesthetics revealed a low overall incidence of emergence delirium, with no significant association found for clonidine, while midazolam appeared to be linked to an increased risk.

Incidence, Predictors, and Outcomes of Early Postoperative Dysnatremia After Pediatric Neurosurgery: A Prospective Observational Study

Jul 29, 2026

This study aimed to evaluate the incidence, predictors, and clinical outcomes of dysnatremia in children undergoing elective neurosurgery. The authors found that 18.6% of the 668 patients experienced postoperative dysnatremia, with preoperative dysnatremia, sellar/suprasellar pathologies, and higher blood loss identified as significant risk factors. Dysnatremia was associated with increased rates of seizures, neurological deterioration, and longer ICU and hospital stays, highlighting its impact on patient outcomes.

A Pilot and Feasibility Study of a Four-Stage Neurological Staging Framework in Pediatric Tracheal Extubation During Anesthesia Emergence

Jul 22, 2026

The authors aimed to evaluate the feasibility of a four-stage neuroanatomical framework for assessing pediatric tracheal extubation during anesthesia emergence and to explore the incidence of respiratory adverse events across these stages. While they successfully assigned emergence stages to all analyzed cases, they identified significant workflow and feasibility barriers, indicating that predefined data capture targets were not met. This pilot study lays the groundwork for refining protocols for a larger multicenter registry.

Intra- and Peri-Operative Cardiac Arrest in Pediatric Patients: Epidemiology, Risk Factors, Mechanisms, and Management Strategies

Jul 22, 2026

The authors investigate the epidemiology, risk factors, mechanisms, and management strategies associated with intraoperative and perioperative cardiac arrest in pediatric patients. They highlight that despite advancements in medical practices, the incidence of these events remains stable, with key risk factors identified as young age, high ASA classification, and underlying health conditions. The review aims to provide clinicians with insights for prevention and effective management of these critical situations.

Automated Versus Manual Endotracheal Tube Cuff Pressure Control in Mechanically Ventilated Children: A Randomized Crossover Trial

Jul 16, 2026

This study aimed to determine whether automated endotracheal tube cuff pressure control is more effective than manual monitoring in maintaining target pressure in mechanically ventilated children. The results showed that automated control significantly reduced the frequency and duration of off-target pressure episodes and decreased nursing workload compared to manual management. The findings suggest that automated cuff pressure regulation enhances airway safety and is preferable in pediatric ventilation settings.

Comparison of Discharge Readiness in Pediatric Patients: Oral Versus Intranasal Preoperative Midazolam Administration

Jul 15, 2026

The authors aimed to compare the effects of oral versus intranasal midazolam on discharge readiness in pediatric patients undergoing tympanostomy, specifically examining the length of stay in the post-anesthesia care unit (PACU). Their findings indicated that while intranasal midazolam initially appeared to result in a shorter PACU stay, this difference was confounded by the younger age of patients receiving this route, with age being the primary predictor of PACU length of stay. The study suggests that previous observations of recovery time differences may be influenced more by age than by the route of midazolam administration, highlighting the need for further research to clarify these relationships.

Routine Replacement of Fasting Deficits in Pediatric Ambulatory Anesthesia: A Propensity-Matched Retrospective Cohort Study

Jul 13, 2026

The authors aimed to determine whether reducing routine fasting-deficit replacement during pediatric ambulatory anesthesia adversely affects intraoperative hemodynamic stability or early postoperative recovery. Their study, involving 8,508 matched pediatric procedures, found that a significant reduction in fasting-deficit replacement did not lead to increased vasopressor use or notable differences in postoperative outcomes. These results suggest that routine empiric fasting-deficit replacement may not be necessary for otherwise healthy children undergoing short ambulatory procedures.

Perspectives in Pediatric Ambulatory Anesthesia: Part 3-One Center's Evolving Regional Anesthesia Experience and Outcomes

Jul 9, 2026

The authors aimed to document the changes and outcomes of regional anesthesia (RA) practices over a 14-year period at a pediatric ambulatory surgery center. They found a significant increase in the use of peripheral nerve blocks, particularly with the introduction of ultrasound, while the use of central neuraxial blocks declined. The study highlights improvements in anesthesia preparation time and clinical outcomes, including reduced pain and opioid use, emphasizing the evolving nature of pediatric RA practices in their facility.