Postoperative epidural analgesia is increasingly popular in paediatric practice, although evidence of its benefit is scarce. We performed a retrospective analysis of a series of 104 consecutive open Nissen fundoplications, to determine whether mode of analgesia, epidural (n=65) or opioid infusion (n=39), influenced certain outcome measures, including intensive care utilization, duration of hospital stay, morbidity and mortality. The two groups were similar in terms of demographic characteristics and associated pathologies. Overall, morbidity and mortality (2%) rates were low. Mean duration of hospital stay was significantly greater for the opioid group, compared to those receiving epidural analgesia (13 vs. 8 days, P < 0.05). The number of patients who remained in hospital for more than 7 days was also significantly greater in the opioid group. Accepting the limitations of a retrospective study, these data suggest that epidural analgesia might be associated with an improved outcome following Nissen fundoplication and this merits a prospective study.

COVID-19 presents an unprecedented challenge to hospitals and the systems in which they operate. The primary exponential surge of COVID-19 cases is arguably the most devastating event a hospital will face. In some countries, these surges during the initial outbreak of the disease have resulted in hospitals suffering from significant resource strain, leading to excess patient mortality and negatively impacting staff wellbeing. As experience builds in managing these surges, it has become evident that agile, tailored planning tools are required. The comprehensive hospital agile preparedness (CHAPs) tool provides clinical planners with six key domains to consider that frequently create resource strain during COVID-19; it also allows local planners to identify issues unique to their hospital, system or region. Although this tool has been developed from COVID-19 experiences, it has potential to be modified for a variety of pandemic scenarios according to transmission modes, rates and critical care resource requirements.

Aim Coronavirus disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), originated in December 2019 from Wuhan, China. This virus has spread worldwide, with over 16 million cases and over 650,000 deaths. The novel coronavirus disease (COVID‐19) has resulted in significant impact on the livelihoods of the British public and has had implications for healthcare delivery. The cancellation of elective procedures is likely to affect Oral Surgery specialty training. This paper aims to ascertain the extent of any impact of COVID‐19 on Oral Surgery specialty training. Material and Methods A survey was created for Oral Surgery specialty trainees in the UK. A variety of questions were used, including multiple choice, yes/no, Likert scales and free text answers. All questions were related to the impact of COVID‐19 on training. Results A total of 34 full responses were recorded. Results showed that COVID‐19 has had an immense impact on Oral Surgery training, with most trainees recording high anxiety levels regarding the future of their training. The overall experience of most trainees involved a reduction in logbook procedures, cancelled study days, courses or conferences. Conclusion Though oral surgery training has been deficient during this period, some trainees reported positive experiences while redeployed in other fields or specialties. In addition, we highlight the significant effect on trainees’ mental health. Most trainees suggested a training period extension to remedy deficiencies. From this paper, we identify the wide‐ranging effects of the pandemic, and Oral Surgery trainees now await decisions on the future of specialty training.

With high levels of anxiety among trainees, those with responsibility for training must enable a fair and flexible approach to assessment.