WSSA Spring Scientific Meeting Session III

In Pursuit of Opioid-Free Pediatric Surgery – What We Learned and How It Changed Our Practice

David Liston, MD, MPH
Assistant Professor, Pediatric Anesthesiologist
Seattle Children's Hospital
Part I 

Sarah Bain, MD
Associate Program Director 
Division Head Cardiovascular, Thoracic, and Structural Heart Anesthesia
Cardiac Anesthesiologist and Intensivist
Virginia Mason Franciscan Health Hospital
Part II

About This Session

Part I:

What started as an iterative improvement effort to determine the “best” anesthetic for pediatric tonsillectomies turned into a systematic change aimed at minimizing all opioids at our pediatric ambulatory surgery center.

Part II:

We recently completed a retrospective review of open-heart cardiac surgical cases performed with a novel opioid free anesthesia protocol utilizing dexmedetomidine.  When compared with traditional opioid based anesthesia techniques in cardiac surgery, no difference was observed with respect to hemodynamic stability with induction or  postoperative outcomes including 24hour MED and antiemetic use, time to extubation, or length of ICU or hospital stay. 

Learning Objectives:  

Part I: 

1. Describe how the opioid crisis has affected pediatric perioperative patients and our profession’s role moving forward. 
2. Discuss how the implementation of standardized protocols can benefit clinical practice. 
3. Explain how easily accessible clinical data supported the reduction of opioid administration in pediatric ambulatory surgery.

Part II: 

1. Recall traditional anesthetic approaches to cardiac surgery.
2. Review reasons to minimize opioid usage in the perioperative setting.
3. Become familiar with a novel opioid free anesthesia approach to cardiac surgery.

About David Liston, MD, MPH

Dr. Liston is a pediatric anesthesiologist at Seattle Children’s Hospital and an assistant professor in the Department of Anesthesiology and Pain Medicine at the University of Washington in Seattle. He received his Bachelor of Science with honors from New Mexico State University and his medical degree from Baylor College of Medicine in Houston. Pursing an interest in global health, Dr. Liston completed an MPH at the Yale School of Public Health before returning to Texas for residency. The University of Texas Southwestern in Dallas served as his training institution for residencies in both pediatrics and anesthesiology. He then finished his training with a fellowship in pediatric anesthesiology at Seattle Children’s Hospital.

Dr. Liston’s passion for global health is demonstrated by his service as the vice chair on the Society for Pediatric Anesthesia’s global health committee. His clinical interests include quality improvement with standardized care, opiate free anesthesia, pediatric regional anesthesia and the study of perioperative anxiety in children. His family life revolves around his wife and three children (spanning elementary, middle and high school).

About Sarah Bain, MD

Sarah Bain, MD is a cardiac anesthesiologist and intensivist at Virginia Mason Hospital in Seattle, WA. She is currently an Associate Program Director for the Anesthesia Residency Program, and Division head of Cardiac, Thoracic and Structural heart Anesthesia.

She attended Emory University in Atlanta, GA for undergraduate training and George Washington University in Washington, DC for medical school and internship. She completed residency in Anesthesia and fellowships in Cardiac Anesthesia and Critical Care Medicine at Stanford University in California. Following fellowship, she was a member of the anesthesia and critical care teams at El Camino Hospital in Mountain View, California and has now been at Virginia Mason Hospital for the last 4 years.

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