Featuring expert TIVA and pEEG speakers this webinar will be perfect for expanding your paediatric TIVA practice.

REGISTRATION: 

Registration is now open, and you can secure your place by completing Zoom Webinar Registration

Please note that this is a free webinar with a limited number of attendees, available on a first-come, first-served basis.

If you are unable to attend, we kindly ask that you do not register, or, if your plans change after registering, that you cancel your registration so that another colleague may take your place.

We’re keen to hear from:

We invite you to contribute to our National Survey on Neonatal Anaesthesia Training – Survey extended until 30 March 2026.

Your insights will play a vital role in improving training, education, and support for both current trainees and early-career consultants nationwide.
Take a few minutes to make a lasting impact!

PaedIatric caNcelation ratEs And PerioPerative clinicaL Evaluation (PINEAPPLE): A UK Prospective Multi-Center Observational Cohort Study https://doi.org/10.1111/pan.70082

PINEAPPLE is a PATRN and APAGBI collaborative UK Prospective Multi‐Center Observational Cohort Study highlighting the importance of paediatric pre-operative assessment, particularly its role in the reduction of anxiety and potential for reduction in on-the-day cancelation due to intercurrent illness. We hope that this work opens conversations for the further development of paediatric pre-assessment services.

The PATRN committee would like to thank all those involved with the study and all centres that contributed to data collection. Collaboration is vital in furthering paediatric anaesthetic research and we as a committee are thankful for all the support that the study has received from its respective centres and teams. 

Information about the PINEAPPLE study, and other PATRN projects, can be found on the PATRN Pages

AI Generated Infographic

The APA is conducting a national survey to map current practice regarding preoperative clear fluid fasting in children and young people - your help is needed to build a National picture of practice.

Access the survey using the above link, or alternatively, scan the QR code

Completion typically requires 10 to 15 minutes. Participation is voluntary. Responses are collected anonymously.
Please do circulate the link within your department and regional networks to support broad and representative participation across tertiary paediatric centres and mixed practice hospitals.
The APA will use the survey results to inform its update of the National Position Statement on Clear Fluid Fasting to ensure that the update is both evidence-based and pragmatic.

Thank you for your time and for contributing to this essential piece of national policy work.

Johnny Kenth, Karen Bartholomew

Prolonged preoperative fasting exposes children to unnecessary thirst, irritability, hypoglycaemia and avoidable intravenous fluid therapy, yet it persists because United Kingdom guidance still mandates that clear fluids stop one hours before anaesthesia. The evidence base has now shifted. The 2025 European Preoperative Fasting Audit (EuroFAST, 18 531 paediatric cases in 271 centres) demonstrated that healthy elective patients who were allowed clear fluids until transfer to theatre had no increase in pulmonary aspiration or airway complications. Parallel Sip Til Send (STS) pilot programmes in the United Kingdom, Ireland and Australia reproduced this safety record while halving median fasting times and improving parental comfort scores.

Current practice across the United Kingdom remains heterogeneous: some centres are early adopters of STS, others permit clear fluids until one hour before induction, and some still enforce a two‑hour restriction.  The 2018 APAGBI statement endorsed a one hour interval; however, recent rigorous evidence from EuroFAST now justifies adoption of STS, whereby children may continue to drink clear fluids until they are summoned to theatre. To translate this evidence into a uniform national standard, APAGBI will deliver three interlocking work packages that provide the requisite data, narrative and consensus.

WP 1 Hot Topic 
WP1 will produce a concise, peer reviewed synthesis of the EuroFAST data set and related wider literature, giving clinicians an accessible rationale for STS adoption and caveats. 
Sip Til Send Hot Topic 

WP 2 National Survey 
WP2 will map current fasting policy, identify barriers to implementation and provide a baseline against which change can be measured. A second survey six-twelve months after publication of the new guidance will quantify progress.

WP3 Updated APA Position Statement on Clear Fluids Fasting
WP3 will use the survey insights and Hot Topic synthesis to craft and publish the updated APAGBI guidance, supported by coordinated dissemination through the APAGBI network and publication in Anaesthesia journal.

Completion of all three work packages by September 2026 will enable evidence informed roll out of STS and provide a framework for ongoing audit.

Leads
1.     Johnny Kenth (JK) – Consultant Clinical Academic, Royal Manchester Children’s Hospital; Chair, APAGBI Scientific Committee
2.     Karen Bartholomew (KB) – Consultant Anaesthetist, Calderdale and Huddersfield FT; President, APAGBI

Working Members
Toni Brunning (TB) – Consultant Anaesthetist, Worcestershire Acute Hospitals NHS Trust; Vice President | Royal College of Anaesthetists; APAGBI Council.
Vimmi Oshan (VO) – Consultant in Paediatric Anaesthesia, RMCH; APAGBI Neonatal Anaesthesia Network; Co-author EuroFAST
Zoë Burton (ZB) – Consultant Anaesthetist, Sheffield Children’s FT; APAGBI Link Network Lead
Catalina Stendall (CS) – Consultant Anaesthetist, Birmingham Children’s Hospital; Chair, APAGBI Education CommitteeTrainee Members- TBC

The Extra Mile Nomination Form 2026
This award is designed to recognise anaesthetists with a paediatric interest in the UK and Ireland, who are clearly exceptional in all aspects of their clinical practice, but who also are driven to go “the extra mile” to deliver teaching and training, colleague support, well-being improvement and inclusivity for the wider department, or are recognised as the 'unsung hero' of the anaesthetic department.
We would ask that all APAGBI members consider who within their department might fit the bill and would encourage you to submit a nomination.

Nominations should clearly outline how the candidate demonstrates the qualities that distinguish them from their peers including some of the defining characteristics shown below:

Full details are included on the nomination form. All nominations will be considered by the APAGBI Officers who will choose the successful recipient.
Please read carefully and note the closing date for receipt of nominations of 30th March 2026.

At the time of Marks passing a Much Loved Tribute Page was set up where you can see some of the wonderful connections that made during his time. 

Election details can be found on the Election Pages 

Becoming a member of the APAGBI Council gives you the opportunity to contribute to the development of services for children undergoing anaesthesia and surgery. This could involve representing children’s services at national meetings, developing guidelines, standards and educational resources, coordinating quality improvement work and also promoting useful resources for children and parents. It also involves representing and responding to the 1000 members of the APAGBI.

There are lots of additional roles that can kbe taken on within council such as education, professional standards and science leads. This work does require a certain time commitment but is very rewarding.

The full council meets twice a year in London, and once at the ASM wherever that may be each year. We are looking for both recently appointed consultants as well as experienced ones. So, if you are interested in joining us, please stand for election.

The election will be held during March/April 2026 and will be conducted by the Civica Electoral Service. Home Members are appointed for four years.

Newly elected Council members will be expected to attend the council meetings and at occasional ad hoc meetings as required. The first meeting of the elected term will be Wednesday 10th June 2026 (an afternoon face-to-face meeting, preceding the 2026 ASM in Plymouth) – please save the date to ensure availability if elected.

Submission deadline is Monday 16th March.

Abstracts are invited in one of four key areas:

Submit Now

This is in response to shortages of commercially prepared local anaesthetic infusions. During this period of supply disruption, hospitals may be supplied with substitute products, different to their usual epidural infusion bags.  

Following consultation with the NHS & APAGBI, the RCoA have provided a summary of additional clinical advice that will be useful to members while managing this issue.

As outlined in the National Patient Safety Alert, all Trusts are required to assemble a multi-professional working group under the leadership of an appropriate senior anaesthetist, in order to undertake a set of required actions and oversee the safety of patients in relation to this supply disruption. 

Read the advice now.

Vote Now Sip Til Send Edu-torial 

This Hot Topic is accompanied by the publication of the APA Infographic Fasting Guidelines Before a General Anaesthetic and is dedicated to Mark Thomas, Consultant in Paediatric Anaesthesia at Great Ormond Street Hospital and former President of the Association of Paediatric Anaesthetists of Great Britain and Ireland.

Mark was instrumental in advancing the shift from a conventional two-hour clear fluid fasting policy to a more progressive one-hour approach. He was driven by a clear vision to ameliorate the burden of unnecessary prolonged preoperative fasting in children and to embed more evidence-informed, child-centred fasting practices into paediatric anaesthesia. This Hot Topic & Infographic builds on the trajectory he established, by evaluating the current evidence base and implementation considerations for allowing children to drink clear fluids up until call to theatre.

Friday 28th November The Victoria, Sheffield

Open to all. Come and join the link network for a friendly day of education, with a top quality programme

Registration now open

Events Page

https://mark-thomas-2025.muchloved.com/

You can read Dr Mark Thomas' obituary published in Pediatric Anesthesia (2025), 35: 1102-1102.

The Edinburgh International Conference Center is ready for the APAGBI & SPA 2025 Annual Scientific Meeting.
With two parallel streams, how will you fit it all in! #timemachine 

Not to worry, the sessions will be recorded and made available for delegates after the event.  

APAGBI 2025 Meeting Programme

Download 2024 Link Survey

We are pleased to announce that abstract submission is now open until the 28th February 2025.

Submission details can be found on our events site 

Abstract categories 

]]> James Farrant Tue, 17 Dec 2024 21:13:15 +0000 https://apastaging.adeptwebdesign.co.uk/news/latest-news/post/15-statement-on-caudal-anaesthesia-nrfit-frorm-ra-uk-apagbi Download Statement on The use of NRFit™ needles for caudal anaesthesia

Caudal anaesthesia is the injection of local anaesthetic drugs into the epidural space via the caudal canal to provide pain relief after a range of common surgical procedures in younger children. Approximately 20,000 children per year undergo caudal anaesthesia for pain relief in the United Kingdom

NHS England (NHSE) has mandated that all relevant NHS-funded organisations must complete the transition to using NRFit connectors by 31 January 2025, for all intrathecal and epidural procedures and for delivery of regional blocks2; this includes caudal procedures. NRFit™ connectors have been designed to prevent the accidental injection of local anaesthetic agents into intravascular devices, which is a potentially fatal event and considered a “never event” by NHSE.

Similarly, the Guidelines for the Provision of Anaesthetic Services (GPAS) published by the Royal College of Anaesthetists (RCoA) earlier this year, state that regional anaesthesia needles (spinal, epidural and peripheral nerve block) must have yellow colour-coded NRFit™ connections. This is required as a minimum standard for the safe delivery of regional anaesthesia

In the United Kingdom, the most practised technique for caudal anaesthesia is to inject local anaesthetic into the caudal canal with a soft cannula-over-needle device, reducing the potential risk of dural puncture with a rigid needle. In a survey of UK paediatric anaesthetists in 2021, 88% of practitioners used such a cannula technique to perform a caudal block.

Currently, there are no soft-cannula NRFit™ options available - which therefore precludes the most practised technique in the UK. The only NRFit™ ‘caudal’ needles that exist on the market are non-cannulated with a blunt ‘Crawford bevel’ (see appendix 1).

There is significant concern amongst paediatric anaesthetists in the UK that the available NRFit™ equipment does not meet current requirements, and it is evident that this will not become available by the mandated time to use NRFit™ compatible equipment in January 2025.

As a result, we are writing to industry to consider the production of suitable equipment to support current practice. NHSE should investigate an NRFit™ cannula solution for caudals to be developed, in accordance with existing evaluation and approval by medical technology regulatory bodies and this should be made readily available to ensure equitable access of children to the safety benefits offered by the NRFit™ system.

We appreciate that, for many anaesthetists, the use of a blunt tipped non-cannulated needle to perform a caudal would be a significant change in practice. Expecting clinicians to significantly alter a reliable and safe technique by reverting to the use of a needle technique with an unclear profile of complications, may result in the introduction of increased risk to the child which may outweigh the benefits of using an NRFit™ system.

Some anaesthetists may have already adopted an alternative technique using the currently available NRFit™ equipment and we encourage them to continue to share their experience. In particular, the use of real-time ultrasound may help mitigate against some potential complications such as accidental dural puncture when using a needle- based technique.
We recommend the following statements to anaesthetists:

Clinicians should be supported in continuing to administer local anaesthetic into the caudal canal using the current well established non-NRFit™ soft cannula-over-needle technique.

Individual trusts should risk assess the practice of caudal anaesthesia at a local governance level to ensure all possible mitigations are in place to minimise wrong route injection of local anaesthetic. This should be added to the local risk register. Departments should remain aware of developments in
NRFit™ equipment and review their position regularly.

This may include the following safe practice points:promoting the safe practice of a ‘stop’ moment before regional anaesthesia is commenced

drawing up of the local anaesthetic drug immediately before injection into the caudal space.

Once completed, any remaining local anaesthetic drugs should be discarded immediately.

The priority remains the safety of our paediatric patients and therefore we feel this offers the best mitigation whilst appropriate equipment is developed. We would welcome comment from our members on this statement.

Dr Nat Haslam President RA-UK
Dr Simon Courtman President APAGBI

The Podcasts can be found on Buzzsprout and Apple Podcasts & Spotify

This lists the ASM podcasts currently published

Join us at the Leonardo Hotel, Cardiff on the 11th October 2024 

This award of £500 for a submission on regional analgesia in children is open to trainees or consultants within 5 years of appointment in May 2024. They should be the first author of the paper.

The submission should be formed of a complete paper and an abstract based on either:

The submission will be 4,000 words or less.

This prize will not necessarily be awarded every year but only if a submission of sufficient quality is received, as judged by a panel convened by the Scientific Committee of the APAGBI.

The prize winner will be expected to make a 15-minute presentation on the topic to the APA Annual Scientific Meeting in Newcastle in May 2024.

The closing date for submission will be March 1st 2024.

Dr Annabel Pearson, Bristol Royal Hospital for Children the winner of the 2023 Dr Roddie McNichol Prize for Regional Anaesthesia in Children with "New Blocks on the Kids"

Dr Akhil Gupta receiving the inaugural Dr Roddie McNicol for Regional Analgesia in Children on ‘Paediatric Epidural Analgesia: A 20 year review of practice in a tertiary hospital’

All APAGBI members should look out for their voting links from Civica Election Services

All candidates supporting statements are available on the Civica voting pages. 

We have 10 fantastic candidates

✅ Iain Belford    
✅ Zoe Burton
✅ Babette Clinck
✅ Lisa Daniels    
✅ James Farrant    
✅ Katie Misselbrook    
✅ Katy Nicholson    
✅ Zoe Ovenden    
✅ Mari Roberts    
✅ Catalina Stendall

Voting now open for @APAGBI council positions. We have ]]> joss Tue, 30 Jul 2024 11:47:01 +0000 https://apastaging.adeptwebdesign.co.uk/news/latest-news/post/4-statement-on-removal-of-pipeline-nitrous-oxide This News article was first published on the Royal College of Anaesthetists Site www.rcoa.ac.uk

Pipeline nitrous oxide should no longer be considered as a means of supplying nitrous oxide in modern anaesthetic practice, according to leading anaesthetic organisations in the UK and Ireland who are calling for nitrous oxide manifolds to be decommissioned. The recommendation relates to pipeline pure nitrous oxide only, meaning that nitrous oxide will remain available via point-of-use cylinders in circumstances where it is judged beneficial to patient care.   

Decommissioning will enable trusts and health boards to save money and reduce their environmental impact while maintaining the highest standards of anaesthetic care for patients. It will not affect use of Entonox, a mixture of nitrous oxide and oxygen commonly known as ‘gas and air’ and used for pain relief, including for women in labour.   

The recommendation comes in the form of a new consensus statement led by the Royal College of Anaesthetists (RCoA), in partnership with the Association of Anaesthetists, the College of Anaesthesiologists of Ireland (CAI), the Obstetric Anaesthetists’ Association (OAA) and the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI). 

Consensus statement on removal of pipeline nitrous oxide

Many anaesthetists have already moved away from routine nitrous oxide use in general anaesthesia and the new guidance will give trusts and health boards the clinical steer they need to decommission manifolds of cylinders within hospitals.  

The majority of manifolds have a significant leak, with 80-100% of nitrous oxide leaking out to the atmosphere before reaching the point of delivery. This is costly and has an environmental impact because nitrous oxide is a long-lived greenhouse gas with an atmospheric lifetime of over 100 years. Decommissioning pipelines will support NHS net zero goals and have financial savings for trusts and health boards.  

The consensus statement recommends the transition from nitrous oxide manifolds is completed by the end of the 2026/2027 financial year in the UK and the Republic of Ireland. Trusts and health boards are advised to liaise with their supplier of nitrous oxide to ensure the increased demand for point-of-use nitrous oxide cylinders can be met and maintained.  

Dr Helgi Johannsson, Vice President and Sustainability Lead of the Royal College of Anaesthetists, said: 

“For the first time, all the leading anaesthetic organisations in the UK and Ireland are giving clear clinical guidance that we don’t need pipeline pure nitrous oxide in order to maintain the highest standards of anaesthetic care for our patients. We hope this new guidance will give trusts and health boards the backing they need to get rid of leaky manifolds in hospitals, which will reduce greenhouse gas emissions and save money.” 

Dr Ken Barker, Chair of the Association of Anaesthetists Environment and Sustainability Committee of the Association of Anaesthetists, said:  

“This joint statement addresses a wasteful practice that has allowed unnecessary leakage of nitrous oxide, a long lived climate pollutant, from NHS hospitals. Simply by providing this gas where and when it is required for patient care via local cylinders rather than hospital wide pipeline systems, clinicians can substantially reduce the NHS carbon footprint without compromising safety or standards.”  

Dr Tim Meek, President Elect of the Association of Anaesthetists, said: 

“The recommendation to decommission nitrous oxide manifolds is the culmination of hard work by all the individual sustainability teams involved in making it happen. Small changes add up, and this enhances anaesthesia's place as one of the prime movers in improving health care sustainability.” 

Dr Dónall Ó Cróinín, Chair of the Sustainability Committee of the College of Anaesthesiologists of Ireland, said: 

“This is a very important declaration from anaesthesia groups in Ireland and Britain. It will empower stakeholders to decommission leaky nitrous oxide systems. It will give anaesthesiologists more control on the how the super-potent greenhouse gas nitrous oxide is brought into their workplaces which will ultimately reduce global warming. Anaesthesia continues to lead the greening of modern healthcare and we hope other specialties will follow.”