Research Overview

My clinical and research activities are focused on modalities to reduce acute, procedural and postoperative pain in children. My recent work has focused on specific modalities to reduce pain for children undergoing open and robot-assisted laparoscopic urologic surgery. This has involved clinical research with the intravenous nonsteroidal medication, ketorolac, evaluating its safety and efficacy as well as its effect on bladder hyperreactivity (bladder spasms) after urologic surgery and the development of new treatment modalities to reduce diffuse abdominal and shoulder pain after laparoscopic surgery. I have recently expanded my research and advocacy focus to investigation of perioperative outcomes after common pediatric surgeries. As clinical director of the surgical hospitalist program at Boston Children's Hospital at Waltham and a member of the American College of Surgeons Task Force for Children's Surgical Care, I am involved in local and national outcomes research for children's surgery.

 

Education

Medical School

University of Kansas Medical Center
1983 Kansas City AR

Internship

University of Kansas Medical Center
1984 Kansas City KS

Residency

Pediatrics University of Kansas Medical Center
1987 Kansas City KS

Residency

Anesthesia Georgetown University Medical Center
1989 Washington DC

Fellowship

Pediatric Critical Care/Pediatric Anesthesia Children's Hospital National Medical Center
1991 Washington MA

Publications

  1. Neurodevelopmental Outcomes Following Early Childhood Anesthetic Exposure: Consideration of Perioperative Health Disparities. J Neurosurg Anesthesiol. 2025 Jan 01; 37(1):138-140. View Abstract
  2. Considerations of Health Care Disparity in Study Design. J Neurosurg Anesthesiol. 2025 Jan 01; 37(1):135-137. View Abstract
  3. Protecting Children and Condemning Hate During a Time of War. Pediatrics. 2024 Mar 01; 153(3). View Abstract
  4. Sedation Research in Critically Ill Pediatric Patients: Proposals for Future Study Design From the Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research IV Workshop. Pediatr Crit Care Med. 2024 Apr 01; 25(4):e193-e204. View Abstract
  5. Evolution of the American College of Surgeons Children's Surgery Verification Program: Implications for optimizing multidisciplinary surgical care of the pediatric patient. Semin Pediatr Surg. 2023 Apr; 32(2):151276. View Abstract
  6. Brain Health in Children: Advocacy and Engaging Stakeholders. J Neurosurg Anesthesiol. 2023 01 01; 35(1):114-118. View Abstract
  7. Preventing Home Medication Administration Errors. Pediatrics. 2021 12 01; 148(6). View Abstract
  8. Availability of Inpatient Pediatric Surgery: Comment. Anesthesiology. 2021 12 01; 135(6):1158-1159. View Abstract
  9. Preventing Home Medication Administration Errors. Pediatrics. 2021 Nov 01. View Abstract
  10. AAP Perspective: Race-Based Medicine. Pediatrics. 2021 10; 148(4). View Abstract
  11. Optimal Pediatric Surgical Care Necessitates Optimal Postoperative Pain Management. Comment on JAMA Surg. Published online November 27, 2020. doi:10.1001/jamasurg.2020.5045. 2020. View Abstract
  12. Truth, Reconciliation, and Transformation: Continuing on the Path to Equity. Pediatrics. 2020 09; 146(3). View Abstract
  13. Optimizing Resources in Children's Surgical Care: An Update on the American College of Surgeons' Verification Program. Pediatrics. 2020 05; 145(5). View Abstract
  14. Educational Perspectives: Anesthesia 101: What the Neonatologist Needs to Know About Anesthesiology. Neoreviews. 2020 01; 21(1):e1-e13. View Abstract
  15. Drugs Used to Treat Pediatric Emergencies. Pediatrics. 2020 01; 145(1). View Abstract
  16. Population Pharmacokinetics of Intraperitoneal Bupivacaine Using Manual Bolus Atomization Versus Micropump Nebulization and Morphine Requirements in Young Children. Anesth Analg. 2019 10; 129(4):963-972. View Abstract
  17. Anesthesia Exposure in Children: Practitioners Respond to the 2016 FDA Drug Safety Communication. J Neurosurg Anesthesiol. 2019 Jan; 31(1):129-133. View Abstract
  18. Neurotoxicity of Anesthesia in Children: Prevention and Treatment. Curr Treat Options Neurol. 2018 Oct 13; 20(12):51. View Abstract
  19. Anesthetic Exposure and Neurodevelopmental Outcomes in the Neonate. NeoReviews. 2018; 19(10):e601-e609. View Abstract
  20. Optimization of Pediatric Surgical Care Is Not the Same as Regionalization. JAMA Surg. 2018 10 01; 153(10):970-971. View Abstract
  21. American College of Surgeons Children's Surgery Verification Quality Improvement Program: What Anesthesiologists Need to Know Now. Anesth Analg. 2018 05; 126(5):1624-1632. View Abstract
  22. Interpretation of Do Not Attempt Resuscitation Orders for Children Requiring Anesthesia and Surgery. Pediatrics. 2018 05; 141(5). View Abstract
  23. Not Just Individuals: The Importance of Collaborative Systems of Pediatric Surgical Care. Anesth Analg. 2017 08; 125(2):692. View Abstract
  24. Hyperkalemia After Laparoscopic Nephrectomy in Patients With Renal Insufficiency: A Case Report. A A Case Rep. 2017 Aug 01; 9(3):69-72. View Abstract
  25. The American College of Surgeons Children's Surgery Verification and Quality Improvement Program: implications for anesthesiologists. Curr Opin Anaesthesiol. 2017 Jun; 30(3):376-382. View Abstract
  26. Fifty years of the American Academy of Pediatrics Section on Anesthesiology: a history of our specialty. Paediatr Anaesth. 2017 Jun; 27(6):560-570. View Abstract
  27. Anaesthetic considerations for surgery in newborns. Arch Dis Child Fetal Neonatal Ed. 2017 Jul; 102(4):F359-F363. View Abstract
  28. Optimal Timing of Surgical Procedures in Pediatric Patients. J Neurosurg Anesthesiol. 2016 Oct; 28(4):395-399. View Abstract
  29. Codeine: Time to Say "No". Pediatrics. 2016 10; 138(4). View Abstract
  30. Institutional Policy Changes to Prevent Cardiac Toxicity Associated With Bupivacaine Penile Blockade in Infants. A A Case Rep. 2016 Aug 01; 7(3):71-5. View Abstract
  31. Robotic surgery and anesthesia for pediatric urologic procedures. Curr Opin Anaesthesiol. 2016 Jun; 29(3):337-44. View Abstract
  32. Prevention and Management of Procedural Pain in the Neonate: An Update. Pediatrics. 2016 Feb; 137(2):e20154271. View Abstract
  33. Critical Elements for the Pediatric Perioperative Anesthesia Environment. Pediatrics. 2015 Dec; 136(6):1200-5. View Abstract
  34. Reply to a Letter to the Editor. J Pediatr Surg. 2015 Aug; 50(8):1434-6. View Abstract
  35. Reply: To PMID 24468231. J Am Coll Surg. 2014 Aug; 219(2):327. View Abstract
  36. Referral to pediatric surgical specialists. Pediatrics. 2014 Feb; 133(2):350-6. View Abstract
  37. Recognition and management of iatrogenically induced opioid dependence and withdrawal in children. Pediatrics. 2014 Jan; 133(1):152-5. View Abstract
  38. Optimal resources for children's surgical care in the United States. J Am Coll Surg. 2014 Mar; 218(3):479-87, 487.e1-4. View Abstract
  39. The feasibility of robotic urologic surgery in infants and toddlers. J Pediatr Urol. 2013 Dec; 9(6 Pt B):1198-203. View Abstract
  40. Development, implementation, and initial participant feedback of a pediatric sedation provider course. Teach Learn Med. 2013; 25(3):249-57. View Abstract
  41. Parent and patient perceptions of robotic vs open urological surgery scars in children. J Urol. 2013 Jul; 190(1):244-50. View Abstract
  42. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics. 2012 Nov; 130(5):e1391-405. View Abstract
  43. A comparative direct cost analysis of pediatric urologic robot-assisted laparoscopic surgery versus open surgery: could robot-assisted surgery be less expensive? J Endourol. 2012 Jul; 26(7):871-7. View Abstract
  44. Robotic assisted laparoscopic ureteral reimplantation in children: case matched comparative study with open surgical approach. J Urol. 2011 May; 185(5):1870-5. View Abstract
  45. Long-term experience and outcomes of robotic assisted laparoscopic pyeloplasty in children and young adults. J Urol. 2011 Apr; 185(4):1455-60. View Abstract
  46. Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics. 2010 Mar; 125(3):608-15. View Abstract
  47. Society for Pediatric Anesthesia/American Academy of Pediatrics/Congenital Cardiac Anesthesia Society: winter meeting review. Anesth Analg. 2010 Jan 01; 110(1):266-71. View Abstract
  48. The effectiveness of aerosolized intraperitoneal bupivacaine in reducing postoperative pain in children undergoing robotic-assisted laparoscopic pyeloplasty. J Pediatr Urol. 2008 Oct; 4(5):337-40. View Abstract
  49. Prevention and management of pain in the neonate: an update. Pediatrics. 2006 Nov; 118(5):2231-41. View Abstract
  50. Transdermal analgesia with local anesthetics in children: review, update and future directions. Expert Rev Neurother. 2005 Sep; 5(5):625-34. View Abstract
  51. Do-not-resuscitate orders for pediatric patients who require anesthesia and surgery. Pediatrics. 2004 Dec; 114(6):1686-92. View Abstract
  52. Relief of pain and anxiety in pediatric patients in emergency medical systems. Pediatrics. 2004 Nov; 114(5):1348-56. View Abstract
  53. Sensory fibers resistant to the actions of tetrodotoxin mediate nocifensive responses to local administration of endothelin-1 in rats. Pain. 2004 Aug; 110(3):719-726. View Abstract
  54. Guidelines for referral to pediatric surgical specialists. Pediatrics. 2002 Jul; 110(1 Pt 1):187-91. View Abstract
  55. Thoracic epidural catheters placed by the caudal route in infants: the importance of radiographic confirmation. Paediatr Anaesth. 2002 Jun; 12(5):424-8. View Abstract
  56. Sedation, risk, and safety: do we really have data at last? Pediatrics. 2001 Oct; 108(4):1006-8. View Abstract
  57. Verve and Jolt: deadly new Internet drugs. Pediatrics. 2000 Oct; 106(4):829-30. View Abstract
  58. Appropriateness of endotracheal tube size and insertion depth in children undergoing air medical transport. Pediatr Emerg Care. 2000 Oct; 16(5):321-7. View Abstract
  59. Ketorolac suppresses postoperative bladder spasms after pediatric ureteral reimplantation. Anesth Analg. 2000 Jul; 91(1):11-5. View Abstract
  60. Perioperative white matter degeneration and death in a patient with a defect in mitochondrial oxidative phosphorylation. Anesthesiology. 1997 Aug; 87(2):420-5. View Abstract
  61. The value of end-tidal CO2 monitoring when comparing three methods of conscious sedation for children undergoing painful procedures in the emergency department. Pediatr Emerg Care. 1997 Jun; 13(3):189-93. View Abstract
  62. Acute intraoperative endotracheal tube obstruction associated with a heat and moisture exchanger in an infant. Anesth Analg. 1997 Apr; 84(4):939-40. View Abstract
  63. Pediatric pain management and therapeutic strategies. J Back Musculoskelet Rehabil. 1997 Jan 01; 9(3):265-78. View Abstract
  64. Patient-controlled analgesia for mucositis pain in children: a three-period crossover study comparing morphine and hydromorphone. J Pediatr. 1996 Nov; 129(5):722-8. View Abstract
  65. Safety of intravenous ketorolac therapy in children and cost savings with a unit dosing system. J Pediatr. 1996 Aug; 129(2):292-6. View Abstract
  66. A double-blind evaluation of ketorolac tromethamine versus acetaminophen in pediatric tonsillectomy: analgesia and bleeding. Anesth Analg. 1995 Feb; 80(2):226-9. View Abstract
  67. Pain management in pediatrics. West J Med. 1993 Feb; 158(2):178-9. View Abstract

Contact Constance Houck