Division of Perioperative Anesthesia
Active clinical, translational, and laboratory research investigations are being carried out in various areas within the Perioperative Anesthesia Division. All research proposals undergo expert peer review by the Perioperative/MOR scientific review committee prior to Boston Children's Internal Review Board submission and approval. Academic and scientific excellence with innovation to improve patient-centered care and answer important perioperative clinical questions is the continued goal. Numerous collaborations exist between researchers within and outside the Perioperative Division. Funding is substantially from inter-departmental support, including trailblazer and ignition grants, while many projects also have extramural funding and grants. The Pediatric Anesthesia Research Center (PARC) facilitates and coordinates research project submission with principal investigators, ongoing updates, and amendments to the IRB, along with facilitating the patient and family confidentiality consent process, data collection and database maintenance, and tracking and reporting project activity.
At the center is the goal to improve care and outcomes for pediatric patients and families undergoing anesthesia, surgery, invasive procedures, and testing at Boston Children’s Hospital. Furthermore, dissemination locally, nationally, and internationally via scientific abstracts, presentations, sharing at medical meetings, and via scientific publications is important to distribute relevant and reliable scientific knowledge. It is the hope that scientific research within the Perioperative Division contributes towards improving the perioperative care of children worldwide.
The following specific research projects are highlighted:
- examine the risk of anesthetic neurotoxicity in infants undergoing longer general anesthetics
- phase 2/3, prospective, open-label trial evaluating the efficacy, safety, and pharmacokinetics of new medication for intravenous sedation in pediatric patients
- examine the effects of sedative medication on gastrointestinal smooth muscle by observing changes in anorectal manometry before and after sedative administration
- determine the feasibility and acceptability of enhanced preoperative education using an interactive tool, designed for children ages 4 through 10 years and their families, compared to the standard preoperative education currently provided
- compare the perioperative care, incidence of emergence agitation, postoperative negative behaviors, and developmental regression after general anesthesia in children with an autism spectrum disorder in comparison to children without any history of neurodevelopmental concerns
- multicenter registry which captures information relating to the perioperative anesthesia course and management of children undergoing ACL reconstruction and to examine practice patterns and incidence of complications
- can use of low dose propofol with dexmedetomidine be effective undergoing MRI while sparing exposure to the high dose of the sedative
- perform preliminary validation of new measurement tool to assess adjustment in a population of young children undergoing surgery
- an international study to define and determine what outcomes should we use to measure the success of anesthesia and perioperative care in children
- patient blood management in children undergoing non-cardiac surgery who are at risk for blood loss and blood transfusions
- perioperative hematologic optimization in infants and children undergoing open repair for craniosynostosis surgery
- the use of thromboelastography to manage and diagnose bleeding and coagulation abnormalities in children undergoing procedures with high anticipated blood loss
- preoperative anemia diagnosis and management in pediatric patients
- acupuncture to aid in managing pediatric chronic pain postoperatively
- determine whether high-flow nasal cannula oxygen supplementation during surgical or endoscopic procedures can prevent desaturation events in children under anesthesia and improve the outcomes of that surgery
- the use of high-flow nasal cannula as transnasal humidified rapid-insufflation ventilatory exchange in pediatric patients undergoing microdirect laryngoscopy and/or bronchoscopy
- gastric assessment of pediatric patients undergoing surgery in relation to fasting times
- intraoperative EEG monitoring of children undergoing pial synangiosis
- the role of soluble adhesion molecules in children with moyamoya syndrome
- coagulation defects in patients undergoing craniotomies
- adhesion molecules and cerebral ischemia
- the role of chemokines in the evolution of stroke injury
- toxicity of nmda-blocking agents in the developing brain
- use of transcranial doppler and other noninvasive techniques to better understand the effects of anesthetics on cerebral function
- exploring the potential role of specific monoclonal antibodies in attenuating these types of injury in infants. Mice with genetic "knockouts" of genes coding for various adhesion molecules are produced at the medical school and tested in a variety of ischemia/reperfusion tissue damage models to explore the role of these genes.
- exploration of cell volume regulation in the brain and the role of cell volume disturbances in brain injury of various types