AUA: Poster Session B: Moderated Discussion Session: Pediatric Anesthesiology

Fri, 5/17: 3:30 PM  - 5:00 PM 
AUA Poster Session 
1.5 
The Fairmont Queen Elizabeth 
Room: Place du Canada / Square Dorchester  

Presenter

Dr. J. Lance Lichtor, MD

Presentations

B189. Distraction as a means of providing procedural anxiolysis for a three year old with severe biventricular cardiomyopathy

Children presenting for surgical interventions that, while generally performed under anesthesia, may be precluded by the severity of underlying cardiopulmonary disease requiring the anesthesiologist to use alternative means of providing procedural analgesia while maintaining patient comfort and anxiolysis. Distraction techniques are beneficial when the risk of anesthesia is deemed excessive and the intervention is not deferable. Described is a patient requiring inguinal hernia repair for recurrent incarceration who was suffering from severe biventricular cardiomyopathy. Audiovisual distraction techniques were used to provide anxiolysis for a regional anesthetic that enable avoidance of general anesthesia. 

Submissions


Poster Presenter

Dr. Adam Adler, MD, MS, FAAP

B190. Exposure to Surgery and Anesthesia in Early Childhood and Subsequent Use of Stimulant Medication

Introduction: Recent clinical studies have found that anesthetic exposure in early childhood is not associated with lower scores in general intelligence and academic achievement. Some studies however have reported worse scores in behavioral function and an increased risk of attention deficit/hyperactivity disorder (ADHD).(1-3) This study evaluates the association between exposure to surgery and anesthesia, and the subsequent use of stimulant medications used to treat ADHD. Significant discrepancies between ADHD diagnoses and stimulant medication use have been reported.(4) The use of stimulant medication however is an important outcome because it is patient centered, requiring recognition of a need for pharmacological treatment and for parents to fill the prescriptions for their child, and may also be a marker of more severe disease. 

Submissions


CoAuthor(s)

Guohua Li, MD, DrPH
Ms. Xiaoyue Ma, BSc
Mark Olfson, MD, MPH
Ming Sun, MS
Melanie Wall, PhD

Poster Presenter

Dr. Caleb Ing, MD, MS

B191. Children and Adults with Congenital Heart Disease Show No Difference in Scores on Measures of Behavior as Compared to Their Healthy Peers: A Systematic Review and Meta-analysis

Children with congenital heart disease (CHD) are at higher risk for cognitive dysfunction compared to their healthy peers.1,2 Several reports have also indicated these children have an increased risk of behavioral problems,3,4 which may place them at higher risk for impaired educational attainment and a later diagnosis of mood disorders.5,6 To test the hypothesis that children with CHD have increased behavioral problems on validated parental and teacher reports of behavioral symptoms, we performed a meta-analysis of Total Problems scores on behavioral measures in children with CHD versus healthy children. 

Submissions


CoAuthor(s)

Dr. Mohammad Sadat, MD
Dr. Lena Sun, MD, MPH

Poster Presenter

Dr. William Jackson, MD

B192. Opioid-Sparing Analgesic Usage Among Pediatric Anesthesiologists: A Survey of Society for Pediatric Anesthesia Members

There is growing evidence to support the perioperative use of opioid-sparing analgesic medications in the pediatric population, but the use of, and attitudes toward, these agents among pediatric anesthesiologists is unknown. We designed a survey to characterize the utilization and views of opioid-sparing adjuncts among pediatric anesthesia practitioners. 

Submissions


CoAuthor(s)

Dr. Thomas Anderson, PhD, MD
Dr. Rebecca Wu, MD

Poster Presenter

Dr. Michael King, M.D.

B193. Intranasal Insulin Prevents Anesthesia-induced Cognitive Impairment in Juvenile Mice

Anesthetics administered at the extremes of age trigger long-term morphological and functional changes in the brain. Pre-clinical studies in rodents and non-human primates correlate early-life, repeated or prolonged general anesthesia (GA) with neurotoxicity and sustained neurobehavioral deficits. This is in-line with pediatric epidemiological studies that associate longer or repeated anesthesia with cognitive and behavioral problems including: neurodevelopmental delay, learning disabilities, and attention deficit/hyperactivity disorder. Moreover, anesthetic and sedative agents were cited in 2016 and 2017 updates of the U.S. FDA Drug Safety Communication, warning they may negatively impact brain development when administered to young children. The mammalian brain is rich in insulin receptors. Insulin administered intranasally to healthy and cognitively-impaired adults has been shown to increase regional brain perfusion, hippocampal function, and verbal memory. We developed a mouse model to determine how early-life intranasal insulin treatment could mitigate anesthetic-induced neurotoxicity on cognition during adulthood. We hypothesized that insulin administered intranasally to juvenile mice prior to anesthesia exposure would exert a neuroprotective effect to prevent anesthesia-induced cognitive impairment during adulthood. 

Submissions


CoAuthor(s)

Mr. Mehdi Hooshmandi, PhD Neuroscience
Dr. Arkady Khoutorsky, PhD
Dr. YOSUKE NAKADATE, MD, PhD
Dr. Tamaki Sato, MD
Dr. Hiroaki Sato, M.D., Ph.D.
Linda Wykes, PhD
Ms. Shelly Yin, BSc Neuroscience

Poster Presenter

Dr. Patricia Roque, MD, PhD C