Anaesthesia Safety and Quality at ASPA 2022

As an anaesthesiologist who has worked for decades in this domain, it gives me immense satisfaction to see that paediatric anaesthesia as a branch of medicine and an essential component of surgery has started getting its desired recognition globally and regionally. I remember when I started my career, we were all textbook-dependent and gained experience through real-time case handling, we barely had platforms to come together as a community, exchange knowledge, and learn from each other, which is an integral process of capacity building.

Anaesthesia, particularly in cleft surgery, plays a very crucial role. An anaesthesiologist is responsible for the preoperative assessment of the cleft child, an evaluation process that carefully considers both the patient’s current state of health and the planned surgical procedure that allows anaesthesiologists to make judgments about the safest anaesthesia plan for each individual patient. The anaesthesiologist is also responsible for the well-being of the patient both intra-operatively and postoperatively while the patient undergoes or emerges from the effects of anaesthesia. These are all critical stages, and I personally feel a sense of satisfaction as a paediatric anaesthesiologist in the daily clinical and cleft surgical processes which not only bridge the facial structural gaps but also build the overall confidence of the child to live a normal, equal and quality life.

It was indeed a great pleasure to be a part of the meeting of paediatric anaesthesiologists at the recently held Asian Society of Paediatric Anaesthesiologists (ASPA) Conference 2022 in Istanbul, Turkey. I sincerely extend my gratitude to Smile Train for considering to be a platinum sponsor of a conference which is so directly and integrally related to the work that Smile Train is doing. Hundreds of anaesthesiologists from across the region participated in the conference and we had some amazing brain stimulating and challenging sessions.

The conference, which was hybrid, had the theme ‘Revisiting Paediatric Anaesthesia – Merging East and West’. It gave the participants an opportunity to listen to and learn from doyens of the field of paediatric anaesthesia (often virtually), meet leaders in the field from Asian countries, communicate in person, try out new equipment and voice their queries and have their doubts answered and clarified.

The meeting started with four ‘hands-on’ workshops – paediatric perioperative life support, regional anaesthesia and ultrasound, intravenous access and management of the difficult airway – the last of which I was involved in. These workshops gave the delegates a chance to discuss their problems with mentors and faculty from across the globe. During the difficult airway workshop, there were talks on difficult intubation, extubation, apnoic oxygenation, what can go wrong and how to deal with it as well as on teamwork and preparedness and the new Difficult Airway Guidelines. Delegates also got an opportunity to handle video laryngoscopes, fiberoptic bronchoscopes, attempt one-lung ventilation on frozen tissue models and discuss basics with cleft and syndromic children in view.

During the conference, a special session was conducted on the Difficult Airway in Syndromic Children. We heard from Vietnam and the Philippines about the challenges they face especially in providing safe anaesthesia in remote areas. The session ended with a talk on problems and solutions in the urban setting.

Throughout ASPA 2022 we heard speakers and participants stressing on the need for safety, quality, education and collaboration. It is good to know that ASPA conducts these meetings on an annual basis, the next one being in Seoul, South Korea in June next year. ASPA also conducts free webinars – the ASPA FLEX series (see the ASPA website for details) on a monthly basis. ASPA and Smile Train are considering a collaboration on conducting training for anaesthesiologists and nurses in Perioperative Paediatric Life Support for cleft children in the near future. All these ventures will go a long way in empowering our paediatric anaesthesiologists and making the world a safer, happier place for children with clefts and their parents.