We present the largest evaluation of interobserver consistency in ASA PS in pediatric patients by pediatric anesthesiologists. We conclude that agreement between anesthesiologists is only moderate and suggest standardizing assessment, so that it reflects the patient status at the time of anesthesia, including any acute medical or surgical conditions.

Preliminary results show that homocysteine levels are not consistently correlated with N 2 O exposure. No clinical or biochemical adverse effects related to the gas have been detected. Conclusion: This interim analysis suggests that repeated N 2 O has a marginal effect on vitamin B12 metabolic indices in predisposed children. The study is on-going. This study is supported by a grant from SPANZA.

Summary An 18-year-old man with metastatic femoral osteosarcoma had inadequate pain control with gabapentin, naproxen, and intravenous fentanyl. A tunneled femoral nerve catheter was used to administer a continuous infusion of 0.2% ropivacaine and 4 μg/mL clonidine (10 mL/h) until his death 88 days later. During discharge from hospital, catheter disconnection resulted in severe pain and readmission. Tunneling, aseptic insertion technique, antibiotics, and sterile infusate prepared by pharmacy may have reduced the chance of infection. We propose that this is a suitable and effective technique in the long-term management of patients with terminal cancer and should be considered on a case-by-case basis.

Objectives This study in children and young adults having cancer-related amputation aimed to examine the incidence of phantom limb pain in the first year after amputation and also the proportion of patients who had pre-amputation pain. Methods A retrospective review of medical records was undertaken. The proportion of patients with phantom limb pain was reported. Fisher’s exact test was used to examine the association between phantom limb pain and the presence of pre-amputation pain and between phantom limb pain and age (≤18 years vs. >18 years). Results 26 amputations were performed on 25 patients. During the year following amputation, 76% of patients had experienced phantom limb pain at some time. After 1 year, though, only 10% still had phantom limb pain. Pre-amputation pain was present in 64% of patients. Although both of our patients with PLP at 1 year were young adults (≥18 years) and both had pre-amputation pain, we found no statistically significant associations between age or the presence of pre-amputation pain with phantom limb pain. Discussion Phantom limb pain following cancer related amputation in children and young adults appears to be common but generally short lived in most patients.

Objectives and Aims-The primary aim was to determine the frequency of anesthetic-related complications for patients with malignant infantile osteopetrosis (MIOP) before and after hematopoietic stem cell transplant (HSCT). The secondary aims were to describe the types of complications that occurred, to determine whether the risk of anesthetic complications was altered by HSCT, and to determine the frequency of difficult intubation.Background-Patients with MIOP undergo HSCT, often in infancy, and anesthesia is frequently required for investigations and procedures associated with transplantation. Although MIOP has adverse implications for anesthetic management, the literature describing anesthetic management of MIOP patients is limited.