Research

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Joseph P. Cravero, MD

Joseph Cravero MD
Department:
Department of Anesthesiology, Perioperative and Pain Medicine Research
Research Focus Area:
Outcomes Research for Anesthesia and Procedural Sedation

Research Overview

1. Analysis of Outcomes from General Surgical Cases at Boston Children's Hospital. This project involves the creation of an integrated database that allows our research group to evaluate the relationship between patient personality types, anesthesia technique, and surgery VS. outcomes including short-term (PACU) outcomes as well as longer-term behavioral outcomes. This project has already yielded data comparing anesthesia/surgery techniques and parental satisfaction, patient personality and post-operative outcomes, and anesthesia technique and postoperative agitation.

2. Our research group has created a national data-sharing group to evaluate the analgesia techniques and outcomes after chest wall surgery in children and adolescents. This group - the Society for Pediatric Anesthesia Improvement Network uses an internet-.based data collection technology to aggregate data from 8 major pediatric centers across the country. 3. The outcomes group is pursuing a project 'The Pediatric Sedation State Scale' - in which we are validating a new scale that will codify the state of a child during a procedural sedation experience This project uses video of actual sedation encounters and allows grading of these videos by multiple sedation providers to compare the state of children during procedures.

Publications

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  1. Devji TF, Madenci AL, Carpino E, Leahy IC, Samnaliev M, Dearden JL, Weil BR, Weldon CB, Cravero J. Safety and cost-effectiveness of port removal outside of the operating room among pediatric patients. J Pediatr Surg. 2016 Nov; 51(11):1891-1895.
  2. Sulton C, McCracken C, Simon HK, Hebbar K, Reynolds J, Cravero J, Mallory M, Kamat P. Pediatric Procedural Sedation Using Dexmedetomidine: A Report From the Pediatric Sedation Research Consortium. Hosp Pediatr. 2016 Sep; 6(9):536-44.
  3. Beach ML, Cohen DM, Gallagher SM, Cravero JP. In Reply. Anesthesiology. 2016 Aug; 125(2):425-6.
  4. Cravero JP, Sriswasdi P, Lekowski R, Carpino E, Blum R, Askins N, Zurakowski D, Sinnott S. Creation of an integrated outcome database for pediatric anesthesia. Paediatr Anaesth. 2016 Apr; 26(4):345-55.
  5. Peyton J, Cravero JP. The pretracheal stethoscope useful, but not a necessity. Paediatr Anaesth. 2016 Mar; 26(3):256-8.
  6. Havidich JE, Beach M, Dierdorf SF, Onega T, Suresh G, Cravero JP. Preterm Versus Term Children: Analysis of Sedation/Anesthesia Adverse Events and Longitudinal Risk. Pediatrics. 2016 Mar; 137(3):e20150463.
  7. Beach ML, Cohen DM, Gallagher SM, Cravero JP. Major Adverse Events and Relationship to Nil per Os Status in Pediatric Sedation/Anesthesia Outside the Operating Room: A Report of the Pediatric Sedation Research Consortium. Anesthesiology. 2016 Jan; 124(1):80-8.
  8. Tsze DS, Mallory MD, Cravero JP. Practice Patterns and Adverse Events of Nitrous Oxide Sedation and Analgesia: A Report from the Pediatric Sedation Research Consortium. J Pediatr. 2016 Feb; 169:260-5.e2.
  9. Lobo K, Donado C, Cornelissen L, Kim J, Ortiz R, Peake RW, Kellogg M, Alexander ME, Zurakowski D, Kurgansky KE, Peyton J, Bilge A, Boretsky K, McCann ME, Berde CB, Cravero J. A Phase 1, Dose-escalation, Double-blind, Block-randomized, Controlled Trial of Safety and Efficacy of Neosaxitoxin Alone and in Combination with 0.2% Bupivacaine, with and without Epinephrine, for Cutaneous Anesthesia. Anesthesiology. 2015 Oct; 123(4):873-85.
  10. Biber JL, Allareddy V, Allareddy V, Gallagher SM, Couloures KG, Speicher DG, Cravero JP, Stormorken AG. Prevalence and Predictors of Adverse Events during Procedural Sedation Anesthesia-Outside the Operating Room for Esophagogastroduodenoscopy and Colonoscopy in Children: Age Is an Independent Predictor of Outcomes. Pediatr Crit Care Med. 2015 Oct; 16(8):e251-9.
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  12. Cravero J, Anderson B, Wolf A. Whither dexmedetomidine? Paediatr Anaesth. 2015 Sep; 25(9):868-70.
  13. Scherrer PD, Mallory MD, Cravero JP, Lowrie L, Hertzog JH, Berkenbosch JW. The impact of obesity on pediatric procedural sedation-related outcomes: results from the Pediatric Sedation Research Consortium. Paediatr Anaesth. 2015 Jul; 25(7):689-97.
  14. Cravero JP, Coté CJ. Raising the bar for pediatric sedation studies and trials. Paediatr Anaesth. 2015 Jan; 25(1):2-4.
  15. Kamat PP, McCracken CE, Gillespie SE, Fortenberry JD, Stockwell JA, Cravero JP, Hebbar KB. Pediatric critical care physician-administered procedural sedation using propofol: a report from the Pediatric Sedation Research Consortium Database. Pediatr Crit Care Med. 2015 Jan; 16(1):11-20.
  16. Muhly WT, Maxwell LG, Cravero JP. Pain management following the Nuss procedure: a survey of practice and review. Acta Anaesthesiol Scand. 2014 Oct; 58(9):1134-9.
  17. Berde CB, Boretsky KR, Cravero JP. Paravertebral block for analgesia after pediatric thoracic surgery. Reg Anesth Pain Med. 2014 May-Jun; 39(3):179-80.
  18. Rosen HD, Cravero JP. Research on emergence agitation in children. Can J Anaesth. 2013 Aug; 60(8):822-3.
  19. Monroe KK, Beach M, Reindel R, Badwan L, Couloures KG, Hertzog JH, Cravero JP. Analysis of procedural sedation provided by pediatricians. Pediatr Int. 2013 Feb; 55(1):17-23.
  20. Hollman GA, Banks DM, Berkenbosch JW, Boswinkel JP, Eickhoff JC, Fagin D, Hagen SA, Hales RL, Houck CS, Kaur T, Kost S, Lowrie L, Nishisaki A, Scherrer PD, Stephenson L, Stormorken A, Cravero JP. Development, implementation, and initial participant feedback of a pediatric sedation provider course. Teach Learn Med. 2013; 25(3):249-57.
  21. Langhan ML, Mallory M, Hertzog J, Lowrie L, Cravero J. Physiologic monitoring practices during pediatric procedural sedation: a report from the Pediatric Sedation Research Consortium. Arch Pediatr Adolesc Med. 2012 Nov; 166(11):990-8.
  22. Fein JA, Zempsky WT, Cravero JP. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics. 2012 Nov; 130(5):e1391-405.
  23. Cravero JP, Fanciullo GJ, McHugo GJ, Baird JC. The validity of the Computer Face Scale for measuring pediatric pain and mood. Paediatr Anaesth. 2013 Feb; 23(2):156-61.
  24. Havidich JE, Cravero JP. The current status of procedural sedation for pediatric patients in out-of-operating room locations. Curr Opin Anaesthesiol. 2012 Aug; 25(4):453-60.
  25. Cravero JP. Pediatric sedation with propofol-continuing evolution of procedural sedation practice. J Pediatr. 2012 May; 160(5):714-6.
  26. Coté CJ, Cravero J. Brave new world: do we need it, do we want it, can we afford it? Paediatr Anaesth. 2011 Sep; 21(9):919-23.
  27. Cravero JP, Havidich JE. Pediatric sedation--evolution and revolution. Paediatr Anaesth. 2011 Jul; 21(7):800-9.
  28. Mallory MD, Baxter AL, Yanosky DJ, Cravero JP. Emergency physician-administered propofol sedation: a report on 25,433 sedations from the pediatric sedation research consortium. Ann Emerg Med. 2011 May; 57(5):462-8.e1.
  29. Couloures KG, Beach M, Cravero JP, Monroe KK, Hertzog JH. Impact of provider specialty on pediatric procedural sedation complication rates. Pediatrics. 2011 May; 127(5):e1154-60.
  30. Trummel JM, Surgenor SD, Cravero JP, Gordon SR, Blike GT. Comparison of differing sedation practice for upper endoscopic ultrasound using expert observational analysis of the procedural sedation. J Patient Saf. 2009 Sep; 5(3):153-9.
  31. Cravero JP. Risk and safety of pediatric sedation/anesthesia for procedures outside the operating room. Curr Opin Anaesthesiol. 2009 Aug; 22(4):509-13.
  32. Cravero JP, Beach ML, Blike GT, Gallagher SM, Hertzog JH. The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium. Anesth Analg. 2009 Mar; 108(3):795-804.
  33. Carayannopoulos AG, Cravero JP, Stinson MT, Sites BD. Use of regional blockade to facilitate inpatient rehabilitation of recalcitrant complex regional pain syndrome. PM R. 2009 Feb; 1(2):194-8.
  34. Baxter AL, Bernard PA, Berkenbosch JW, Blike G, Cohen DM, Connors JM, Cravero JP, Fagin DH, Freilich S, Havidich J, Hertzog JH, Hollman G, King L, Kost S, Leder M, Linzer J, Litman RS, Lowrie L, Lubisch NB, Mallory M, Scherrer PD, Stockwell JA, Werner DA. Society for Pediatric Sedation reply to Dr Cote's editorial. Paediatr Anaesth. 2008 Jun; 18(6):559-60; author reply 560-1.
  35. Baxter AL, Mallory MD, Spandorfer PR, Sharma S, Freilich SH, Cravero J. Etomidate versus pentobarbital for computed tomography sedations: report from the Pediatric Sedation Research Consortium. Pediatr Emerg Care. 2007 Oct; 23(10):690-5.
  36. Fanciullo GJ, Cravero JP, Mudge BO, McHugo GJ, Baird JC. Development of a new computer method to assess children's pain. Pain Med. 2007 Oct; 8 Suppl 3:S121-8.
  37. Cravero JP, Blike GT, Beach M, Gallagher SM, Hertzog JH, Havidich JE, Gelman B. Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. Pediatrics. 2006 Sep; 118(3):1087-96.
  38. Cravero JP, Blike GT. Pediatric anesthesia in the nonoperating room setting. Curr Opin Anaesthesiol. 2006 Aug; 19(4):443-9.
  39. Cravero JP. Emergence agitation: time for heavy lifting. J Clin Anesth. 2005 Nov; 17(7):491-3.
  40. Sacchetti A, Cravero J. Sedation in the emergency department. Pediatr Ann. 2005 Aug; 34(8):617-22.
  41. Blike GT, Christoffersen K, Cravero JP, Andeweg SK, Jensen J. A method for measuring system safety and latent errors associated with pediatric procedural sedation. Anesth Analg. 2005 Jul; 101(1):48-58, table of contents.
  42. Cravero JP, Blike GT, Surgenor SD, Jensen J. Development and validation of the Dartmouth Operative Conditions Scale. Anesth Analg. 2005 Jun; 100(6):1614-21.
  43. Dinulos JG, Cravero JP. General anesthesia in infants and children for pediatric dermatologic procedures: is it worth it? Arch Dermatol. 2005 May; 141(5):629-30.
  44. Zempsky WT, Cravero JP. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics. 2004 Nov; 114(5):1348-56.
  45. Cravero JP, Blike GT. Review of pediatric sedation. Anesth Analg. 2004 Nov; 99(5):1355-64.
  46. Mace SE, Barata IA, Cravero JP, Dalsey WC, Godwin SA, Kennedy RM, Malley KC, Moss RL, Sacchetti AD, Warden CR, Wears RL. Clinical policy: evidence-based approach to pharmacologic agents used in pediatric sedation and analgesia in the emergency department. Ann Emerg Med. 2004 Oct; 44(4):342-77.
  47. Mace SE, Barata IA, Cravero JP, Dalsey WC, Godwin SA, Kennedy RM, Malley KC, Moss RL, Sacchetti AD, Warden CR, Wears RL. Clinical policy: evidence-based approach to pharmacologic agents used in pediatric sedation and analgesia in the emergency department. J Pediatr Surg. 2004 Oct; 39(10):1472-84.
  48. Mace SE, Barata IA, Cravero JP, Dalsey WC, Godwin SA, Kennedy RM, Malley KC, Moss RL, Sacchetti AD, Warden CR, Wears RL. Clinical policy: evidence-based approach to pharmacologic agents used in pediatric sedation and analgesia in the emergency department. J Emerg Nurs. 2004 Oct; 30(5):447-61.
  49. Chaimberg KH, Cravero JP. Mucositis and airway obstruction in a pediatric patient. Anesth Analg. 2004 Jul; 99(1):59-61.
  50. Yaster M, Cravero JP. The continuing conundrum of sedation for painful and nonpainful procedures. J Pediatr. 2004 Jul; 145(1):10-2.
  51. Cravero JP, Blike GT. Pediatric sedation. Curr Opin Anaesthesiol. 2004 Jun; 17(3):247-51.
  52. Cravero JP, Beach M, Thyr B, Whalen K. The effect of small dose fentanyl on the emergence characteristics of pediatric patients after sevoflurane anesthesia without surgery. Anesth Analg. 2003 Aug; 97(2):364-7, table of contents.
  53. Mohr JJ, Barach P, Cravero JP, Blike GT, Godfrey MM, Batalden PB, Nelson EC. Microsystems in health care: Part 6. Designing patient safety into the microsystem. Jt Comm J Qual Saf. 2003 Aug; 29(8):401-8.
  54. Maxwell LG, Tobias JD, Cravero JP, Malviya S. Adverse effects of sedatives in children. Expert Opin Drug Saf. 2003 Mar; 2(2):167-94.
  55. Sites BD, Blike G, Cravero J, Andeweg S, Beach M. Single-dose caudal anaesthesia for two infants undergoing diagnostic brain magnetic resonance imaging: high risk and nonhigh risk. Paediatr Anaesth. 2003 Feb; 13(2):171-4.
  56. Polaner DM, Houck CS, Rockoff MA, Mancuso TJ, Finley GA, Maxwell LG, Cravero J, Kain ZN, Bell C, Bosenberg A, Zwass M, Valley R, Agarwal R, Savarese A, Rice LJ, Coté CJ, Davidson PJ, Ferrari LR, Davis PJ. Sedation, risk, and safety: do we really have data at last? Pediatrics. 2001 Oct; 108(4):1006-8.
  57. Blike G, Cravero J, Nelson E. Same patients, same critical events--different systems of care, different outcomes: description of a human factors approach aimed at improving the efficacy and safety of sedation/analgesia care. Qual Manag Health Care. 2001; 10(1):17-36.
  58. Cravero JP, Beach M, Dodge CP, Whalen K. Emergence characteristics of sevoflurane compared to halothane in pediatric patients undergoing bilateral pressure equalization tube insertion. J Clin Anesth. 2000 Aug; 12(5):397-401.
  59. Cravero J, Surgenor S, Whalen K. Emergence agitation in paediatric patients after sevoflurane anaesthesia and no surgery: a comparison with halothane. Paediatr Anaesth. 2000; 10(4):419-24.
  60. Sites BD, Gallagher JD, Cravero J, Lundberg J, Blike G. The learning curve associated with a simulated ultrasound-guided interventional task by inexperienced anesthesia residents. Reg Anesth Pain Med. 2004 Nov-Dec; 29(6):544-8.
  61. Cravero JP, Muffly M. Case presentation: abdominal compartment syndrome complicating posterior spinal fusion. Paediatr Anaesth. 2012 Mar; 22(3):278-80.
  62. Gulur P, Rodi SW, Washington TA, Cravero JP, Fanciullo GJ, McHugo GJ, Baird JC. Computer Face Scale for measuring pediatric pain and mood. J Pain. 2009 Feb; 10(2):173-9.
  63. Merguerian PA, Corbett ST, Cravero J. Voiding ability using propofol sedation in children undergoing voiding cystourethrograms: a retrospective analysis. J Urol. 2006 Jul; 176(1):299-302.
  64. Connors JM, Cravero JP, Kost S, LaViolette D, Lowrie L, Scherrer PD. Great expectations-defining quality in pediatric sedation: outcomes of a multidisciplinary consensus conference. J Healthc Qual. 2015 Mar-Apr; 37(2):139-54.
  65. Rosen HD, Mervitz D, Cravero JP. Pediatric emergence delirium: Canadian Pediatric Anesthesiologists' experience. Paediatr Anaesth. 2016 Feb; 26(2):207-12.
  66. Grunwell JR, Marupudi NK, Gupta RV, Travers CD, McCracken CE, Williamson JL, Stockwell JA, Fortenberry JD, Couloures K, Cravero J, Kamat PP. Outcomes following implementation of a pediatric procedural sedation guide for referral to general anesthesia for magnetic resonance imaging studies. Paediatr Anaesth. 2016 Jun; 26(6):628-36.
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