• Steven Cai and Fiona Taverner.
• Department of Anaesthesia, Prince of Wales Hospital, Sydney, New South Wales, Australia.
• Paediatr Anaesth. 2025 Jan 22.

BackgroundAfter-hours pediatric anesthesia may pose increased risks, with a heightened potential for sudden cardio-respiratory decline. While mortality rates are low in Australia and New Zealand, critical events and morbidity occur more frequently and present ongoing challenges. However, little is known about how trainees are supervised during these high-risk periods.MethodsAn anonymized online survey of members of the Society for Pediatric Anesthesia in New Zealand and Australia (SPANZA) was conducted to explore supervising anesthetists attitudes towards after-hours supervision. The survey examined the influence of patient age, medical history, trainee experience, and surgery type on supervision practices.ResultsRespondents identified age and physical status as key risk factors but reported providing less direct supervision than recommended by international studies, especially for non-complex surgeries in healthy children. Trainee experience was a significant factor in supervision decisions.ConclusionPediatric anesthetists in Australia and New Zealand recognize major risk factors but tend to supervise more remotely after-hours. Further research is needed to evaluate the effects of these supervision practices on outcomes.© 2025 The Author(s). Pediatric Anesthesia published by John Wiley & Sons Ltd.

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