The 5th Congress of the Asian Society of Paediatric Anaesthesiologists (ASPA) at Christian Medical College in Vellore, India
I had a chance to participate, as the past-President of the FEAPA, in the 5th Congress of the Asian Society of Paediatric Anaesthesiologists (ASPA) held in Vellore, Tamil Nadu, India. The followings are my impressions of the meeting and facts and figures were provided by the ASPA members including Professor Rebecca Jacob (the Organizing Secretary) and Masao Yamashita (the President of the ASPA).
The ASPA has developed a tradition of organizing congresses of a remarkably high scientific standard despite the fact that many Asian countries have to fight against unfavorable economic conditions! The 5th congress took place at the Christian Medical College (CMC), Vellore, India, an outstanding institution originally founded by an American missionary. The institution has a history of significant medical inventions and a remarkable record of first procedures in India and in the world.
The congress was organized by the head of pediatric anesthesia in this hospital, Professor Rebecca Jacob in cooperation with the president of the ASPA, Masao Yamashita (Japan). A 1-day workshop on pediatric airway and ultrasound-guided regional anesthesia (USGRA) preceded the congress and a 1-day trauma workshop followed the meeting.
The first workshop on August 31, 2006 was conducted by Josef Holzki (Germany) dealing with the normal and difficult airway, long practice sessions with rigid and flexible endoscopes in manikins were included. The following workshop on ultrasound-guided regional anesthesia (USGRA) was conducted by Manoj Karmakar (Hong Kong) including technical instructions about ultrasound apparatus and exchanging his vast experience in this field with the audience, consisting of very attentive anesthesiologists from nine Asian and four nonAsian countries. Many items of interest could be discussed in detail in the many hours of the workshop settings.
The Congress started on September 1, 2006 very early with free papers. They showed mainly interesting case reports, many on airway problems and challenging problems in neonates, which could be discussed during poster sessions. These were organized on both days, during the lunch session, with prizes awarded for both the best free papers and the posters. The plenary lectures started, according to the focus of the program, with lectures on the pediatric airway and on USGRA.
Josef Holzki gave an overview of the anatomy of the larynx and trachea of the child, showing many real-time photographs of airway trauma, explaining the documentation of airway injury by simple (rigid) and reasonably priced instruments. Mechanisms of trauma were explained, concluding that airway trauma by the anesthesiologist can practically always be prevented.
Manoj Karmakar discussed the many opinions in USGRA. Although randomized studies showing the advantage of USGRA are in the literature, current evidence suggests that ultrasound speeds the execution of peripheral nerve blocks, reduces the discomfort experienced during block placement, reduces the amount of local anesthetic required, speeds the onset of sensory blockade, improves the quality of sensory-motor blockade, prolongs the duration of sensory blockade and may reduce the incidence of complications.
Susan Verghese (USA) covered the most important topic of mishaps in children with cardiac disease undergoing noncardiac operations, pointing at titration of all necessary medications. Rob McDougall (Australia) demonstrated the challenges of pediatric burns for anesthesiologists, concentrating on blood saving techniques.
Two extended case discussions on major abdominal surgery and anterior mediastinal mass, chaired by Shani Tan (Singapore) and Deepak Sreevastava (India) filled the afternoon; well liked by the audience because of the inclusion of many well-known panelists from different countries. The day concluded with a preliminary quiz for postgraduates and the inauguration ceremony.
The inauguration took place solemnly at the Scudder Auditorium, CMC. Welcome address by Dr George Chandy, the Director of CMC, and the presidential address by Masao Yamashita were given. The highlight of the ceremony was a lighting of kuthuvilakuku; wicks were lit by representatives of nine Asian countries (Bangladesh, Bhutan, Hong Kong, India, Japan, Malaysia, Pakistan, Singapore, and Sri Lanka).
September 2 started again after a long session on free papers. Charles Cote ´ (USA) presented the data of an extremely accurate investigation on sedation accidents by nonanesthesiologists in North America. First, he criticized the term conscious sedation as a misleading misnomer which should no longer be used. All deaths and brain damage after sedation mishaps were from drug overdosages, administration of the wrong drug mixture and inadequate supervision of patient.
Neil Matthews (Australia) described the difficulties and dangers of intrahospital transport and retrieval of critically ill children from distant places by air in a vast continent country like Australia.
Robyna Khan (Pakistan) explained the challenges of neonatal anesthesia, updating well-known know ledge, and highlighting the problems in a developing country.
Anesthesia for laparoscopic surgery by Norifumi Kuratani (Japan) and challenges of pediatric thoracic surgery by the pediatric surgeon Sudipta Sen (India) concluded the first part of the second day.
Two highly interesting, extended case discussions, extremely well accepted by the delegates, were conducted on the second day of the meeting. The first was chaired by Elsa Varghese (India): Papilloma of the larynx for laser surgery, showing extreme cases of papilloma, rarely encountered in economically more fortunate countries. The priority of securing the airway was unanimously stressed by the international panelists. The second, chaired by Rob McDougall (Australia), dealt with the Laryngeal Mask Airway and many conflicting opinions about indication and length of use.
The Congress was concluded with a very colorful interesting multimedia quiz finals related to pediatric anesthesia and resuscitation conducted by S. Ramesh (India). There were four teams of two each selected from the preliminary quiz and the Vellore Postgraduates were the winners of the quiz finals.
The pediatric trauma workshop was coordinated byRebeccaJacob,RobMcDougallandNeilMatthews. Therewere60participantsandtheprogramconsisted of two short lectures, five skill stations and eight case discussions. The faculty consisted of the coordinators and senior members of CMC medical staff. A very helpful abstract book accompanied the congress to makethiseventalonglastingeducationalexperience.
The next ASPA meeting will be held at Pattaya Beach, Thailand on November 10, 2007 as a precongress meeting of the 15th ASEAN Congress of Anesthesiologists (further information, visit the ASPA website: http://www.aspa-2000.com/or ACA 07 website: http://www.aca2007.org/2 ).
Josef Holzki M.D.
Department of Anaesthesia, Cologne Children’s Hospital, Cologne, Germany