Using Research to Inform Pain Management
Our research enables us to use the safest and most effective approaches to provide anesthesia care, and helps advance the field of pediatric anesthesiology.
At Children’s Health℠, the choices we make in the clinic are informed by the research we do in anesthesia, pain management and palliative care. As the lead institution on many clinical trials looking at safety and outcomes in these areas, we are national leaders in pediatric clinical anesthesia outcomes research.
The three arms of our pediatric anesthesiology research include:
- Anesthesia. We study how the medications used before and during surgery and after medical procedures impact children, enabling us to provide the safest, most effective care. We are also helping to adapt and study noninvasive monitoring in children.
- Pain management. Children often need help managing pain and anxiety. Our research focuses on both the acute pain associated with surgical procedures and chronic pain that may persist and be debilitating after an accident or trauma. We study ways to address the psychologic aspects of pain management while minimizing the use of opiates and drugs that can impact neurologic development as much as possible. Through this research, we’ve identified pain management solutions that focus on non-pharmacologic interventions such as virtual reality, physical therapy and more.
- Palliative care. Maximizing a child’s quality of life when they are facing complex health issues requires special approaches to care. For these children, we use a team approach that closely incorporates and supports the entire family. We’re helping to identify ways to make life better and more comfortable for kids with chronic and complex health needs
Our focus areas
We prioritize safety, comfort and health at every step of the way. Our research includes:
Finding a safer approach to anesthesia. Anesthesia exposure in early childhood and infancy can impact brain development later in life. Children’s Health is a leading institution on studying how exposure to anesthetic medication at a young age (<3 years) influences later brain development. The study – done with colleagues from 22 centers in the U.S., Canada, Europe, Australia and New Zealand and published in The Lancet – showed that a single, short anesthetic in infants and young children is not harmful. Following that study, the team at Children’s Health led another international study to identify a new technique for anesthetizing young children for surgery that is potentially safer for brain development.
Finding new monitoring solutions for pediatric patients. Most monitors are initially designed for adult patients. Using adult monitors for children is challenging due to the differences in size and physiology in adults and children. The research team at Children’s Health is one of the leading centers in this area. Multiple studies are focused on finding monitoring solutions for our patients using noninvasive, cutting--edge technologies for monitoring hemoglobin, the brain, depth of anesthesia and respiration. In a world premiere, the research group published a monitoring method of detecting a patient’s oxygenation. This method can predict and warn the care staff to impending low oxygenation, half a minute before other monitoring signs or alarms sound. Moreover, an ongoing study in pediatric patients is using a novel finger probe to determine the degree of pain our patients have during surgery.
New solutions for rehabilitation. We’re researching how virtual and augmented reality games can help kids engage with important physical exercises after big medical procedures. These games can help distract kids and guide them through important range-of-motion and physical therapy exercises.
Putting anesthesia under the microscope. We’re researching how anesthesia affects a child on the cellular level. Understanding precisely how a child's cells respond to anesthesia will help us practice safer anesthesiology.
Ensuring quality. We’re always measuring our own success and quality/safety metrics across areas of care. Our focus on children with chronic pain and chronic diseases enables us to develop protocols for team-based care. This care incorporates physical therapists and psychiatric services, reducing the need for prescribed pain medications and helping children to heal while avoiding the risk of opiate dependence.
Leading-edge anesthesiology researchOur research prioritizes helping children bounce back from complex medical procedures and complex chronic pain conditions, whether we are pinpointing best practices for medical interventions or innovating new approaches to helping them recover from surgery without sedative drugs. We are invested in a wide array of pediatric anesthesiology topics because our aim is to help maximize a child’s comfort and quality of life.
Research-driven care, for life
Our scientists’ studies include:
- Laboratory research, which helps teams understand the complex science behind how the body responds to therapies and explore innovative new methods
- Clinical research, which measures how well our methods work and paves the way to groundbreaking approaches
Our leading role in researching the impact of anesthesia on brain, cell and nerve development equips us with the expertise needed to make key decisions around a child’s care. With this level of understanding, we can strategically choose medications that limit negative impacts. We can also supplement medication-based therapies with psychiatric and physical therapy approaches that have proven track records for helping kids recover.
Patients who come to us with pain management needs require fewer doctor’s visits, miss less school, and are more successful as they recover compared to patients who undergo more traditional pain management.
Our ongoing dedication to pediatric anesthesiology research helps us anticipate a child’s needs every step of the way.
A specialized pediatric chronic pain program
We offer one of the only pediatric chronic pain specialty programs in our region. Our impact reaches well beyond North Texas, which means we are actively committed to making contributions that improve the care of children everywhere.
Shaping the next generation of anesthesia leaders
We help train the pediatric anesthesiologists of tomorrow. We’re fully accredited for fellowship training, and we train four pediatric anesthesiology fellows each year. We also work closely with UT Southwestern’s residency training program, which means their residents work in our hospital.
In addition to our fellowship in pediatric anesthesiology, we also support fully accredited advanced fellowships in pediatric cardiac anesthesiology and pediatric chronic pain management. For clinician scientists interested in a focus on outcomes research, we also offer an advanced second-year fellowship focused on clinical outcomes research.
- PUB-20200922-When the Mask Doesn’t Fit: A Modified Bag Mask Technique-Journal of Anesthesia and Perioperative Care-Open Access Journal Volume: 1.2-Edgar E. Kiss, Patrick Olomu
- PUB-20200917-Hyponatremia Is Associated With Increased Mortality in Children on the Waiting List for Liver Transplantation-Transplantation DIRECT 2020-Dmitri Bezinover, MD, PhD, Lauren Nahouraii, MD, Alexandr Sviatchenko, MD, Ming Wang, PhD, Steven Kimatian, MD, Fuat H. Saner, MD, and Jonathan G. Stine, MD
- PUB-20200917-A comparison of videolaryngoscopy using standard blades versus non-standard blades in children within the Paediatric Difficult Intubation Registry-British Journal of Anaesthesia-BJA-2020-00321-TAKA030.R2-Edgar E. Kiss, Gijo Alex, Neethu Chandran, Patrick Olomu
- PUB-20200905-Anesthetic implications of a pediatric patient with stiff skin syndrome: A case report-Pediatric Anesthesia Volume 30, Issue 10-Edgar E. Kiss, Gijo Alex, Neethu Chandran, Patrick Olomu
- PUB-20200817-The Truview PCDTM video laryngoscope for nasotracheal intubation in pediatric patients: A subset analysis from a prospective randomized controlled trial-Pediatric Anesthesia Volume 30, Issue 10-Rita Saynhalath, Proshad Nemati Efune, James, Michael Blackwell, Jeffrey W. Steiner, Patrick N Olomu, Peter Szmuk
- PUB-20200717-The Truview PCD™ video laryngoscope for nasotracheal intubation in pediatric patients: A subset analysis from a prospective randomized controlled trial-Proshad Nemati Efune, Rita Saynhalath, James, Michael Blackwell, Jeffrey W. Steiner, Patrick N. Olomu, Peter Szmuk
- PUB-202007-Pediatric Airway Management in COVID-19 Patients: Consensus Guidelines From the Society for Pediatric Anesthesia’s Pediatric Difficult Intubation Collaborative and the Canadian Pediatric Anesthesia Society-Anesthesia & Analgesia. 131(1):61-73, July 2020-Matava, Clyde T., Kovatsis, Pete G., Lee, Jennifer K., Peter Szmuk, MD, Patrick Olomu, MD, et.al.
- PUB-20200608-Use of dexmedetomidine and opioids as the primary anesthetic in infants and young children: A retrospective cohort study-Pediatric Anesthesia 2020; 30:1013–1019-Proshad N. Efune, John M. Longanecker-Gijo Alex, Rita Saynhalath, Umar Khan, Kevin Rivera, Aveline P. Jerome, Weiwei Boone, Peter Szmuk
- PUB-20200323-Anesthetic Challenges of an Adolescent Patient with Epidermolysis Bullosa and Gitelman's Syndrome Undergoing Posterior Spinal Fusion Surgery-Journal of Pediatric Genetics-Edgar E. Kiss, Neethu Chandran, Gijo Alex
- PUB-20200115-Endotracheal Intubation Using Alfentanil in a Pediatric Patient with a Mitochondrial Myopathy and Gastroparesis-Journal Pediatric Genetics-Sonia D. Mehta, Wendy L Leavitt, Gijo Alex, Rita Saynhalath, Edgar Kiss
- PUB-202001-Thromboelastography-targeted management of severe coagulopathy and off-label use of four-factor prothrombin complex concentrate in an infant with massive bleeding-Blood Coagulation and Fibrinolysis 2020, 30:00–00-Proshad N Efune, Gijo Alex, Janna Journeycake, Sonia D Mehta
- PUB-20181108-Improving Reliability to a Care Goal Rounding Template in the Pediatric Intensive Care Unit-Pediatric Quality and Safety 2018 Nov-Dec; 3(6): e117-Proshad N. Efune, MD; Rustin B. Morse, MD; Maeve Sheehan, MD; Loren M. Malone, MD; Tammy S. Robertson, PNP; Cindy Darnell, MD, MSCS
- PUB-201803-Incidence and factors contributing to postdischarge nausea and vomiting in pediatric ambulatory surgical cases-Paediatric Anaesthesia 2018 Mar;28(3):257-263. doi: 10.1111/pan.13333-Proshad N Efune, Abu Minhajuddin, Peter Szmuk
- PUB-2018-Characterization of upper airway obstruction using cine MRI in children with residual obstructive sleep apnea after adenotonsillectomy-Sleep Medicine 50 (2018) 79e86-Amal Isaiah, Edgar Kiss, Patrick Olomu, Korgun Koral, Ron B. Mitchell
- PUB-2016-Glide Scope® Cobalt AVL Video Baton for Intubation in Infants Weighing Less Than 10Kilograms-Journal Anesthesia Perioperative Medicine 2016; 3: 236-40-Patrick N Olomu, Asif Khan-Jeffrey Steiner, Edgar Kiss, Roxana Ploski, Peter Szmuk