Thomas Drake-Brockman

University of Western Australia | UWA · Medical School

Background: Perioperative respiratory adverse events (PRAE) are the most common critical incidents in paediatric anaesthesia and occur more often in infants. Use of laryngeal mask airways (LMAs) is associated with reduced PRAE compared with endotracheal tubes in older children (>1 year). We aimed to evaluate the effect of these devices on the inci...

Background Head-mounted devices (HMDs) are of significant interest for applications within medicine, including in anesthesia for patient monitoring. Previous devices trialed in anesthesia for this purpose were often bulky, involved cable tethers, or were otherwise ergonomically infeasible. Google Glass is a modern HMD that is lightweight and solves...

Background: Anaesthesia related mortality in paediatrics is rare. There is limited data describing paediatric anaesthesia related mortality. This study determined the anaesthesia related mortality at a Tertiary Pediatric Hospital in Western Australia. Methods: A retrospective cohort study of children under-18 years of age, that died within 30-da...

Background: Monitoring children's recovery postoperatively is important for routine care, research, and quality improvement. Although telephone follow-up is common, it is also time-consuming and intrusive for families. Using SMS messaging to communicate with families regarding their child's recovery has the potential to address these concerns. Whi...

Background Sedation and anesthesia are widely used to relieve pain and ensure cooperation during elective diagnostic and medical procedures in the pediatric population. However, there is currently limited evidence about the recovery trajectory following deep sedation or general anesthesia for such procedures in children. Aims The primary aim was t...

Background A previous cohort of adenotonsillectomy patients at our institution demonstrated moderate-severe post-tonsillectomy pain scores lasting a median (range) duration of 6 (0–23) days and postdischarge nausea and vomiting affecting 8% of children on day 1 following surgery. In this subsequent cohort, we evaluate the impact of changes to our d...

Background Reasons for elective surgery cancellations and their impact vary from one institution to another. Cancellations have emotional and financial implications for patients and their families. Our service has a particularly broad and geographically diverse patient population, hence we sought to examine these impacts in our service. Methods We...

The aim of this prospective cohort study was to describe the anaesthetic practices, rates of postoperative pain and the recovery trajectory of children having urgent dental extractions at our institution. Demographic, anaesthetic and surgical details of children undergoing dental extractions were obtained by case note review. Parent-proxy pain scor...

Follow-up for ongoing management and monitoring of patients is important in clinical practice and research. While common, telephone follow-up is resource intensive and, in our experience, yields low success rates. Electronic communication using mobile devices including smartphones and tablets can provide efficient alternatives — including SMS (text...

Propofol is the most commonly administered intravenous agent for anaesthesia in children. However, there are concerns that the emulsified preparation may not be safe in children with an allergy to egg, peanut, soybean or other legumes. We conducted a retrospective study of children with immunologically confirmed egg, peanut, soybean or legume aller...

Importance Tonsillectomy is a common pediatric procedure for the treatment of sleep-disordered breathing and chronic tonsillitis. Up to half of children having this procedure experience a perioperative respiratory adverse event. Objective To determine whether inhaled albuterol sulfate (salbutamol sulfate) premedication decreases the risk of periop...

Background: Postoperative pain is frequently undertreated in children both in hospital and at home following discharge. Pain has both short- and long-term consequences for children, their families, and the healthcare system. A greater understanding of procedure-specific postoperative pain trajectories is required to improve pain management. Aim:...

Background: Perioperative respiratory adverse events (PRAE) remain the leading cause of morbidity and mortality in the paediatric population. This double-blinded randomized control trial investigated whether inhaled salbutamol premedication decreased the occurrence of PRAE in children identified as being at high risk of PRAE. Methods: Children wit...

Background While there are many proposed predictors for paediatric emergence delirium, clinicians often struggle to predict which children will present with emergence delirium. We conducted an audit to determine if children presenting for elective surgery in costume or with toys had different rates of emergence delirium or pain following surgery. M...

Regional nerve blockade (RNB) is increasingly used in children for perioperative pain management. RNB in children is almost exclusively performed under general anaesthesia, resulting in a greater risk of inadvertent nerve damage. Large international studies have found that RNB in children carries a very low risk of morbidity, and is becoming even s...

Background It is well established that children experience significant pain for a considerable period following adenotonsillectomy. Less is known, however, about pain following other common head and neck operations. Aim The aim of this study was to describe the severity and duration of postoperative pain experienced by children undergoing elective...

Background In paediatric anaesthesia, it is common that surgery cannot proceed as planned for various reasons (some preventable), resulting in rescheduling or cancellation. Cancellations impact operating theatre utilisation and pose financial and emotional costs on children and their families. Methods Following approval by the institutional resear...

Many studies comparing the i-gel™ with laryngeal masks include patients in whom laryngeal mask cuff inflation pressures are higher than recommended, or involve the use of neuromuscular blocking drugs and positive pressure ventilation. We compared the i-gel with the PRO-Breathe® laryngeal mask in anaesthetised, spontaneously breathing children. Two...

IntroductionPain is a subjective experience. In children with limited understanding and communication skills, reliable assessment of pain is challenging. Self-reporting of pain is the gold standard of pain measurement. For children who are unable to self-report their pain, assessments made by their parents are often used as a proxy measure. The val...

Children undergoing anaesthesia are prone to hypothermia. Perioperative monitoring of patient temperature is, therefore, standard practice. Postoperative temperature is regarded as a key anaesthetic performance indicator in Australian hospitals. Many different methods and sites of temperature measurement are used perioperatively. It is unclear to w...