Report on the 4th Scientific Meeting of the Asian Society of Paediatric Anaesthesiologists, September 24–25 2005, in Singapore
The fourth meeting of the Asian Society of Paediatric Anaesthesiologists (ASPA) was held in Singapore on 24 and 25 September 2005 at the auditorium of the Kandang Kerbau (KK) Women’s and Children’s Hospital, at 100 Bukit Timah Road Singapore. There were over 163 participants from 18 countries (Australia, Brunei, Canada, Cambodia, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Netherlands, New Zealand, Thailand, Philippines, Scotland, Singapore, USA and Vietnam). The concerted efforts of the Organizing Committee headed by organizing chairperson, the calm and artistic Josephine Tan (who also designed the logo for ASPA), indefatigable Michelle Tay as the scientific chairperson, ebullient Serene Lim overseeing the social and entertainment aspects all combined to make the event memorable. The subtle influences of the President of ASPA Shani Tan and secretary Agnes Ng were obvious to those who know them.
The theme of the meeting ‘Paediatric Anaesthesia in Evolution’ was very apt for the Asian context as different parts of Asia are in different phases of evolution ranging from advanced state of the art to rudimentary. This was stressed by the opening speaker Dr Arie Utariani representing Dr Herlien Megawe who was unwell. She presented the training of pediatric anesthesiologists in Indonesia and sought the goodwill and active assistance from her Asian counterparts for development of pediatric anesthesia in her country. This was followed by a presentation of the contemporary scientific view on the ancient science of acupuncture. Dr Lakshmi Vas concluding that there was a potential for the use of acupuncture in pediatric sedation in ICU and in burns based on a randomized-controlled study. Dr Sithan from Cambodia spoke about pediatric anesthesia training in Cambodia from personal experiences. This opening session was chaired by Dr G. M. Tan of Singapore and Dr F. G. Dawoodi from Brunei.
In the post-tea session chaired by Dr Serene Lim of KKH, Dr Chalkiadis from the Royal Children’s Hospital, Melbourne stressed ‘getting started’ with developing a pain management service in pediatrics for both acute and chronic pains. He emphasized the team approach to this under-recognized problem. Dr Sandeep Diwan from India reiterated the need for recognition of procedural pain and the various ways to manage this important problem in pediatrics. Dr Rebecca Jacob discussed the thought provoking controversy ‘central neuraxial blocks; are we doing too much?’ She quoted the views of various experts from different parts of the world on this thorny issue. This was followed by a discussion of two case scenarios of ‘Neonatal regional anesthesia or Opioids’, and ‘Analgesia for scoliosis surgery’ by Dr Chalkiadis.
After the posttea session, we enjoyed a sumptuous lunch, which was spiced by presentation of 12 posters to be judged by Drs Raafat Hannallah (USA), Samir Girotra (India) and George Chalkiadis (Australia) who worked very hard indeed for their lunch! The best poster award was given to Dr Aparna Sinha.
In the postlunch session was a mixture of presentations on anesthesia ‘Kids with special needs’ on posttransplant (Dr Kook Hyun Lee, Korea), autistic (Dr Kenji Shigemi, Japan), HIV positive children (Dr Ruenreong Leelanukrom, Thailand), and lastly a child who thinks he is going to the zoo but lands up in OR instead (Dr Shani Tan, Singapore).
Seven oral free papers were presented on new, innovative and ingenious techniques such as ‘externalizing the lungs during tracheoesophageal fistula repair’ and ‘infraclavicular approach to brachial plexus block’ and ‘LMA insertion: at what BIS? to name a few. The paper ‘Antiemetic effects of granisetron vs dexamethasone in clonidine premedicated children undergoing strabismus surgery’ by Dr Indu Sen of Chandighar, India was adjudged the best paper by the judges, Drs John Keneally (Australia), Dilip Pawar (India) and Masao Yamashita (Japan).
Assiduous selection by the organizing committee of thought provoking topics and the pot pourri of speakers from different backgrounds, with vastly differing resources at their disposal provided a chance to review the problems from different angles and highlighted the various modalities of providing humane and safe care to children around the world irrespective of the facilities. Enthusiastic discussion from the floor enlivened the proceedings.
The official business of the day was concluded by holding the fourth General Assembly of the ASPA. There were 29 members attending from seven countries. The outgoing president Dr Shani Tan, welcomed members, gave a brief summary of the activities of the society and welcomed the new President Dr Masao Yamashita from Japan. Dr Wanna Somboonviboon from Thailand is the new President Elect. Dr Kongsayreepong from Thailand as the Secretary and Dr Agnes Ng from Singapore as the Treasurer. Elections were carried out for the new executive committee. Discussions regarding the tracking of members, accepting only US currency as ASPA accounts are based in Singapore and are in both US$ and S$, workshops be conducted during ASPA meetings to generate income, having an electronic letter to ‘keep connected’ either hosted by mass email or ASPA website. The ASPA logo designed by Dr Josephine Tan was approved by all. However suggestions to improve the colors of the alphabet by using primary colors was agreed and also unanimous agreement to omit the syringe.
The Venues for fifth and sixth ASPA meeting were decided. Dr Rebecca Jacob will host an ASPA meeting in year 2006 in Vellore, India with the objective of introducing ASPA to our colleagues in the Indian subcontinent. The sixth ASPA in Pattaya, Thailand as pre ASEAN Congress of Anesthesiologists meeting. Dr John Keneally requested a joint meeting with ASPA for the seventh ASPA in 2009 subject to confirmation from SPANZA. Dr Camagay proposed requesting through ASPA reduced subscription rates for ASPA for Pediatric Anesthesia and other Blackwell publications for members. Dr Masao Yamashita will bring up the matter with the publisher. The crowning glory of the day was the eclectic entertainment organized by Dr Serene Lim. The New President Dr Yamashita accompanied by his charming wife Marie and delightful children all resplendent in Kimonos set the mood for the evening with the Thai contingent performing their national dance, and later Dr Serene Lim falling into step for an Indian Bhangra. The food was delicious with Malay, Singaporean and other delicacies. For the vegetarians it was salads, fruits and ice creams as usual (the sesame flavor was yummy).
There was a piano and violin recital and a hilarious sketch detailing the evolution of Pediatric Anesthesia from the multitalented medical officers of KK Paediatric Anaesthesia. From among the unsuspecting audience that was getting mellow our social secretary collared Drs Chalkiadis, Angeline Gapay, Rachel Pereira and Lakshmi Vas and assigned them to one team and Drs Agnes Ng, Masao Yamashita, Illuminada Camagay and John Kenneally in another team for a game of charades. A contest of silent portrayal of the medical phrases such as ‘Apert’s syndrome’, ‘Bossy nurse’, ‘slow surgeon’, etc. It was rather difficult for all these habitual public speakers to keep quiet while trying to convey an abstract concept! However they managed it and of course the superior team won in spite of a dedicated effort by the KK staff to make their boss’s team win. Dr Ng accepted this considerable ribbing with her usual aplomb by resorting to the attribute of selective auroaural fistula. The evening ended early by 9 PPMM so that people could be present bright and early first lecture of the coming day by the new president.
This all important session chaired by Drs Ong Biau Chi and Dilip Pawar had topics of ‘Research in pediatric anesthesia’ (Dr Yamashita, a member of the editorial board of ‘Pediatric Anesthesia’), ‘Statistics’ (Dr EHC Liu) and ‘Medical writing’ (Dr John P Keneally, Editor Australasian Anaesthesia). As lectures were being delivered by a reviewer, and an editor, delegates were present in large numbers. (What better way to improve CVs than by publication?). All the speakers were very encouraging and considerate to the aspiring novice writers and advised on the do’s and don’ts. Dr Yamashita lost no opportunity to drive home the point that all should read and publish in Pediatric Anesthesia, our own journal.
This was followed session on ‘Problem of pain in children’ chaired by Dr Chalkiadis. Dr Grace Pang of Singapore made a poignant presentation about the ‘Pain management in a dying child’; a problem that anesthesiologists as practitioners of acute medicine are largely unfamiliar with. Dr Lakshmi Vas spoke on ‘Pain management in Guillain Barre syndrome’ highlighting the problem of pain perception in paralyzed preverbal children. Then came our scientific chairperson Dr Michelle Tay herself to speak on ‘The typical child with persistent pain’. The third session in the day comprised topics such as ‘Intraoperative ventilatory problems in preemies’ (Suneerat Kongsereepong), ‘Awareness in the child’ (Dr Illuminada Camagay), ‘Considerations for transfusion in children’ (Angelina Gapay), lastly a dynamic presentation on ‘Quality assurance in pediatric anesthesia’ by Dr Manoj Karmakar from Hong Kong.
The pervading atmosphere of the conference throughout was seemingly effortless, spontaneous, friendly with tongue in cheek teasing of old and new friends; truly a tribute to the organizational skills of the KKH Paediatric Anaesthesia Department and to the delegates ability to enjoy serious academic sessions as well as camaraderie outside.
Finally came the valedictory function with everybody bemoaning the fact that all good things have to come to an end. The group feeling sorry to part with old and new friends lingering after this then decided to go for lunch together.
The fourth ASPA was indeed enjoyable and all of us look forward to the fifth ASPA meeting to be held in Vellore, South India in September 2006, and the sixth in Thailand. (For further information, visit the ASPA website: http://www.aspa-2000.com/).
Lakshmi Vas M.D.
Consultant Paediatric Anaesthesiologist
Children’s Orthopaedic Centre
All India Institute of Physical Medicine and
Rehabilitation Bombay, India
(email: lakshmi1@hotmail.com)
