A 15-year-old boy is undergoing an ACL reconstruction. He is otherwise healthy and has no
relevant past medical history.
Question of the Month – June 2025
A 12‑year‑old male with a known history of congenital methemoglobinemia presents for bilateral inferior alveolar nerve blocks to facilitate extraction of multiple impacted molars. He has no prior anesthetic history and is otherwise healthy. His preoperative hemoglobin is 14.6 g/dL, and his baseline methemoglobin level ranges from 2 % to 14 %. Which of the following is the most appropriate anesthetic management strategy for this patient?
Question of the Month – May 2025
A 7-year-old boy (24 kg) undergoes extensive bilateral lower-extremity orthopedic surgery. Epidural catheter placement under general anesthesia proves technically difficult, requiring several needle passes before a catheter is threaded. Twenty-four hours later he develops a bifrontal, throbbing headache with vomiting that is immediately relieved when supine and recurs on sitting or standing. Conservative therapy—including IV fluids, oral caffeine citrate, acetaminophen, ketorolac, and continuation of the local anesthetic infusion through the catheter—fails to provide durable relief. The parents are hesitant about further neuraxial procedures and ask whether any less-invasive options exist before proceeding to an epidural blood patch.
Which of the following interventions has documented success in children for aborting PDPH:
Question of the Month – April 2025
A 16‐year‐old patient undergoing an open laparotomy had a T12 epidural placed under standard sterile technique. Because the “loss‐of‐resistance” was not crisp and the resident expressed doubt about catheter placement. In addition to the usual epidural test dose of epinephrine, which of the following published methods can help confirm correct epidural catheter placement in pediatric patients?
Options:
A. Epidural Pressure Waveform Analysis
B. Electrical Stimulation (Tsui Test)
C. Fluoroscopic Guidance with Contrast Injection (Epidurography)
D. Ultrasound Confirmation
E. pH Testing of Aspirated Fluid
F. Combined Spinal-Epidural (CSE) Technique
Question of the Month – March 2025
Studies have shown that animal assisted therapy can be a beneficial part of multimodal management of many various symptoms, ranging from depression and anxiety to acute and chronic pain. Animal-assisted interventions (AAI) have been known to improve discomfort, stress, anxiety, and overall well-being in children and adults. In addition to subjective reports from patients, biomarkers have been used to investigate a positive response to AAI. All of the following objective measures have been utilized indicating a positive response to AAI except:
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