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Current Opinion in Anaesthesiology

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https://www.readbyqxmd.com/read/28537937/dexmedetomidine-the-new-all-in-one-drug-in-paediatric-anaesthesia
#1
Cedric E Sottas, Brian J Anderson
PURPOSE OF REVIEW: Dexmedetomidine is a drug with sedative, anxiolytic, sympatholytic and analgesic properties, which is finding widespread practice in paediatric anaesthesia and related practices. The present review summarizes its pharmacology and current experience with the drug. RECENT FINDINGS: Dexmedetomidine is proving useful in many diverse areas in paediatric anaesthesia where its sedative properties are useful for premedication, fibreoptic intubation and radiologic procedures...
May 22, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28509773/perioperative-management-of-antithrombotic-therapies
#2
Timur Yurttas, Patrick M Wanner, Miodrag Filipovic
PURPOSE OF REVIEW: Perioperative coagulation management is becoming increasingly frequent in the daily routine of the anesthesiologist and with the plethora of new substances on the market also increasingly complex. The perioperative setting poses unique challenges requiring an individualized evaluation and management of antithrombotic therapy. This review shall summarize the newest developments in this domain. RECENT FINDINGS: New data in patients with atrial fibrillation have led to a paradigm change in the perioperative management of antithrombotics...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28509772/safety-of-deep-sedation-in-the-endoscopy-suite
#3
Megan L Allen
PURPOSE OF REVIEW: As the complexity of endoscopic procedures increases, the use of propofol and the desire for deep sedation are becoming more common in the endoscopy suite. This review explores sedation depth, agents used for sedation, recommended monitoring, and adverse event risks that occur during sedation for endoscopy. RECENT FINDINGS: The sedation provider for endoscopy varies by practice location and with regulatory requirements. As increasingly deep levels of sedation are used in this setting, the need for all providers to have training in the ability to rescue patients from sedation-related side effects is paramount...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28509771/sedation-for-advanced-procedures-in-the-bronchoscopy-suite-proceduralist-or-anesthesiologist
#4
Michael Kern, Thoralf Kerner, Sascha Tank
PURPOSE OF REVIEW: This article focuses on the issue of sedation provided either by proceduralists or anesthesiologists for advanced bronchoscopy procedures. The relative merits of both approaches are presented. Current evidence from the literature and guideline recommendations relevant to this topic are reviewed. RECENT FINDINGS: In general, patient and proceduralist satisfaction as well as patient safety are increased when intravenous sedation is provided for advanced bronchoscopic procedures...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28509770/tumescent-anaesthesia-its-applications-and-well-tolerated-use-in-the-out-of-operating-room-setting
#5
Natalie F Holt
PURPOSE OF REVIEW: Tumescent anaesthesia is a method of administering dilute local anaesthetic into the subcutaneous tissue. Many anaesthesiologists are unfamiliar with the technique, its applications and potential risks. RECENT FINDINGS: The maximum safe dose of lidocaine with epinephrine in tumescent anaesthesia for liposuction is probably between 35 and 55 mg/kg. Without liposuction, the maximum dose of lidocaine with epinephrine should be no more than 28 mg/kg...
May 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28509774/the-role-of-the-anaesthesiologist-in-air-ambulance-medicine
#6
Stephen J M Sollid, Marius Rehn
PURPOSE OF REVIEW: The care administered on air ambulances has become increasing complex. This has led to a discussion among experts as to whether air ambulance travel should be manned by physicians. This review provides evidence in support of anaesthesiologists being the physician-leaders in air ambulance medicine, because of their training in advanced airway management, critical care, and resuscitation. RECENT FINDINGS: Successful prehospital care requires the ability to perform a complex set of advanced diagnostics and interventions...
May 13, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28463875/training-anesthesiologists-in-out-of-operating-room-anesthesia
#7
Karen J Souter, Wil Van Cleve
PURPOSE OF REVIEW: The purpose of this review is to describe recent developments and current trends in training anesthesiologists in out-of-operating room anesthesia (OORA). RECENT FINDINGS: In the United States, the Accreditation Council for Graduate Medical Education recently updated its training requirements to include a mandatory 2-week rotation in OORA for anesthesiology residents. This likely reflects the continuing expansion of anesthesia services in the out-of-operating room (OOR) environment as well as the increasing complexity of OOR procedures and medical acuity of patients in these settings...
April 29, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28426446/providing-anesthesia-in-resource-limited-settings
#8
Lena E Dohlman
PURPOSE OF REVIEW: The article reviews the reality of anesthetic resource constraints in low and middle-income countries (LMICs). Understanding these limitations is important to volunteers from high-income countries who desire to teach or safely provide anesthesia services in these countries. RECENT FINDINGS: Recently published information on the state of anesthetic resources in LMICs is helping to guide humanitarian outreach efforts from high-income countries. The importance of using context-appropriate anesthesia standards and equipment is now emphasized...
April 19, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28490039/the-implications-of-immunization-in-the-daily-practice-of-pediatric-anesthesia
#9
Gianluca Bertolizio, Marinella Astuto, Pablo Ingelmo
PURPOSE OF REVIEW: Vaccination is an important prevention measure, but requires an intact immune system. Surgery and anesthesia suppress the immune system and may interfere with the benefits of immunization. Moreover, common vaccine side-effects may be misinterpreted as postsurgical complications. This review summarizes the essential basis of immunization and its potential interactions with anesthesia. RECENT FINDINGS: Vaccines have mild side-effects, such as fever, but may lead to serious complications in immunocompromised patients...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28490038/pediatric-sleep-disordered-breathing-an-update-on-diagnostic-testing
#10
Brian McGrath, Jerrold Lerman
PURPOSE OF REVIEW: Recent advances in diagnostic testing for obstructive sleep apnea in children have refined the standard tests while identifying several new tools that hold promise to radically change how we diagnose sleep apnea. RECENT FINDINGS: Studies have demonstrated that the polysomnogram may be modified to permit home assessment of sleep disturbed breathing in children to ensure more widespread access to the test. Alternately, questionnaires, nocturnal oximetry, and diagnostic urinary biomarkers have shown great promise as both sensitive and specific tools to diagnose sleep apnea in children as well as track the severity of the disease...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28448298/anesthetic-consideration-for-neuromuscular-diseases
#11
Jeffery A Katz, Glenn S Murphy
PURPOSE OF REVIEW: The aim of this review is to examine data relating to perioperative management of the patient with neuromuscular disorders RECENT FINDINGS: Patients with pre-existing neuromuscular disorders are at risk for a number of postoperative complications that are related to anesthetic drugs that are administered intraoperatively. Careful preoperative assessment is necessary to reduce morbidity and mortality. In particular, the risk of postoperative respiratory failure and need for long-term ventilation should be reviewed with patients...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28346231/optimizing-patients-undergoing-surgery-opus-part-ii-still-a-matter-of-eminence-based-medicine
#12
Andreas Hoeft, Olaf Boehm, Torsten Baehner
No abstract text is available yet for this article.
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#13
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323672/safety-interventions-on-the-labor-and-delivery-unit
#14
Rachel M Kacmar
PURPOSE OF REVIEW: The present review highlights recent advances in efforts to improve patient safety on labor and delivery units and well tolerated care for pregnant patients in general. RECENT FINDINGS: Recent studies in obstetric patient safety have a broad focus but repetitive themes for interdisciplinary training include: simulating critical events, having open multidisciplinary communication, frequent reviews of cases of maternal morbidity, and implementing maternal early warning systems...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#15
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#16
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323669/quality-maternal-care-a-call-for-anesthesia-leadership-and-collaboration
#17
Jeanette R Bauchat
No abstract text is available yet for this article.
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28319476/anesthesia-in-patients-with-infectious-disease-caused-by-multi-drug-resistant-bacteria
#18
Sharon Einav, Yonit Wiener-Well
PURPOSE OF REVIEW: Up to 50% of specific bacterial strains in healthcare admission facilities are multi-drug resistant organisms (MDROs). Involvement of anesthesiologists in management of patients carrying/at risk of carrying MDROs may decrease transmission in the Operating Room (OR). RECENT FINDINGS: Anesthesiologists, their work area and tools have all been implicated in MDRO outbreaks. Causes include contamination of external ventilation circuits and noncontribution of filters to prevention, inappropriate decontamination procedures for nondisposable equipment (e...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306683/update-in-pediatric-anesthesiology
#19
Lynne R Ferrari
No abstract text is available yet for this article.
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306682/training-future-anesthesiologists-in-obstetric-care
#20
Mauricio Vasco Ramírez
PURPOSE OF REVIEW: In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed. RECENT FINDINGS: Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools...
June 2017: Current Opinion in Anaesthesiology
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