President's Message

Stay Strong, Stay Healthy and Find Beauty and Joy Wherever You Can

By Rita Agarwal, MD, FAAP, FASA
Clinical Professor of Anesthesiology
Stanford School of Medicine
Stanford, California

Dr. Agarwal

This year has been one like no other. So much has happened and there is so much to process that any words from me seem completely inadequate. Between the COVID-19 pandemic, the civil unrest, Black Lives Matter movement, and the painful and unusual national elections, our world has truly been confusing and stressful. Many of us have gotten used to our new circumstances and do our best every day to care for our patients. Meanwhile, guidelines change, restrictions increase, restrictions decrease, politicians’ squabble, and new vaccinations hold out hope. We will continue to take every day as it comes, educate ourselves and prepare for an uncertain future. We hope the updated SPPM website will help make navigating some of these changes easier. We are adding content regularly and would LOVE your help.

As I write this message in the latter days of November, the national elections have been conducted, but chaos continues to reign. On a happier note, the SPPM elections are open and hopefully all of you are voting. Thank you to the Nominations Committee for all their hard work in putting together an outstanding slate of candidates and to Dr. Anjana Kundu for helping create videos for each of the candidates. The video format is a lovely way to get to know candidates better. Please VOTE.

I had hoped to see all of you in February in beautiful San Diego, but alas that is not to be. The 8th Annual SPPM Meeting will be virtual. Dr. Marisa Witkor as the SPPM Annual Meeting Program Chair has been adaptable, flexible, endlessly enthusiastic and always willing to go the extra mile to make the meeting work. Thanks to Marisa, the Education Chair Dr. Robert Wilder and the entire Education Committee for putting together an amazing, multidisciplinary and exciting program for our virtual consumption. I have to admit, while I love lounging around with my various pets listening to groundbreaking and educational content, I REALLY miss seeing you all in person.  I am including photos of my conference companions, who actually seem to enjoy all the additional time with me, (as compared to the surly teenagers who sort of, kind of, tolerate it).

We are delighted to have two new Special Interest Groups (SIGs) and more information can be found about them in both the newsletter and on the website. Consider joining, creating your own SIG and sharing your passions and interests with us. We have added new standing Committees and encourage everyone to GET INVOLVED. Committees are open to anyone with an interest. Contact the Committee Chairs (listed on the Website) to get more information. We need your ideas, your enthusiasm and your support.

Thank you to Dr. Yuan-Chi Lin and the entire Editorial Board of the newsletter. They have produced yet another fantastic edition, this time focusing on regional anesthesia. Despite these incredibly trying times, they have managed to get some ASA abstract reviews on important topics related to pediatric pain management and regional anesthesia. They have a robust, informative section on regional anesthesia that includes topics such as:

• Erector Spinae Plane Catheters for Posterior Spine Fusion Surgery Postoperative Pain Management by Carole Lin, MD; Stephanie Pan, MD and Ban C.H. Tsui, MD
• New Peripheral Nerve Blocks: Are They Worth the Hype? By Adrian Bosenberg, MBChB, FFA (SA) and Erica Holland, MD
• Regional Anesthesia for Pediatric Knee Surgery by Loren Babirak, MD; Elizabeth O’Brien, MD and Wallis Muhly, MD
• Regional Anesthesia for Sickle Cell Disease Vaso-occlusive Crisis by Karla Wyatt, MD, MS and Chyong-jy Joyce Liu, DO, MBA, MS
• Choice of Local Anesthetic Agent for Epidural Infusions in Neonates and Infants: The Case for Chloroprocaine by Emmanuel Alalade MD; Joseph D. Tobias, MD and Ralph J. Beltran, MD
• Infant Spinal Anesthesia: What’s Old is New Again by Marian Murphy, DO and Robert Williams, MD
• Combined Spinal/Caudal Catheter Anesthetic for Surgery in Infants: Practical Considerations by Kristen O. Spisak, MD
• LAST But Not The Least - Pediatric Local Anesthetic Systemic Toxicity by Archana Singaravelu Ramesh, MD and Karen R. Boretsky, MD

We know that this pandemic will have many long lasting and profound effects. After a few years of decreasing opioid overdose related death rates, they have dramatically increased during the pandemic, https://www.ama-assn.org/system/files/2020-11/issue-brief-increases-in-opioid-related-overdose.pdf. A brief survey of participants of the Pediatric Pain Listserve a few months ago revealed that while most people across this and other countries (there were responses from Canada, New, Zealand, England and Australia) had found ways to continue to see and treat their patients using video, internet, telephone or a combination of methods, they were quite concerned about the mental health of these vulnerable children. Most practitioners who answered my brief unscientific survey reported concerns regarding increased anxiety, isolation, depression, unhealthy coping strategies and decreased activity, particularly as the pandemic drags on. At the time of the survey no one was aware of any increased opioid use or misuse in children; however, the risk remains significant.

Special Thanks to the staff at Ruggles who make everything we do possible, who have been amazingly adaptable and visionary during these unusual and trying times. They have created seamless platforms for the SPA Fall Annual Meeting, which I am sure will translate effortlessly to the SPPM Annual Meeting. They have facilitated the changes and updates to the SPPM website and organized our regular Board of Director Meetings.

Please continue to take care of yourselves, your families and your patients. You are irreplaceable and invaluable. Stay strong, stay healthy find beauty and joy wherever you can. If you haven’t already please vote for your future SPPM leaders, I hope to see you all virtually in April and in person soon!

Glorious Fall Color, Palo Alto in November 2020