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anaesthesia, critical care , and pain management

Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
S Moliner Velázquez, R Rubio Haro, C De Andrés Serrano, J De Andrés Ibáñez
Regional analgesia intrinsically, based on its physiological effects, is routinely used for the perioperative treatment of pain associated with surgical procedures. However, in other areas such as the non-surgical treatment of acute pain for patients in a critical condition, it has not been subjected to specific prospective studies. If we confine ourselves to the physiological effects of the nerve block, in a situation of stress, the indications for regional anaesthesia in this group of patients extend to the management of a wide variety of medical as well as postsurgical conditions, of trauma patients and of other painful procedures performed in the patient's bed...
March 2017: Revista Española de Anestesiología y Reanimación
Eric Ehieli, Suraj Yalamuri, Charles S Brudney, Srinivas Pyati
Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critically ill patients in the ICU presents numerous challenges to intensivists. Inconsistencies in pain assessment, analgesic prescription and variation in monitoring sedation and analgesia result in suboptimal pain management. Inadequate pain control can have deleterious effects on several organ systems in critically ill patients...
January 2017: Postgraduate Medical Journal
E Hoerner, K Schebesta, M Hüpfl, O Kimberger, B Roessler
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Syeda Fauzia Hasan, Mohammad Hamid
BACKGROUND AND AIMS: Incident reporting is a reliable and inexpensive tool used in anaesthesia to identify errors in patient management. A hospital incident reporting system was already present in our hospital, but we were unable to find any incident related to acute pain management. Hence, acute pain service (APS) was started for voluntary incident reporting in post-operative patients to identify critical incidents, review the root cause and suggest remedial measures. METHODS: All post-operative patients managed by APS were included in this observational study...
December 2015: Indian Journal of Anaesthesia
F Peerbhay, F Titinchi
INTRODUCTION: Dental caries is a common condition amongst young children that negatively impacts on their quality of life, It is an added burden on children with special healthcare needs (CSHCN) who have an increased risk of developing caries due to the high sugar contents in their medications, regular consumption of cariogenic foods and a poor salivary flow. AIMS AND OBJECTIVES: to analyse the management of dental caries in CSHCN at a tertiary public hospital in South Africa...
June 2014: SADJ: Journal of the South African Dental Association
Marieke de Vries, Gerhard Putter
CLINICAL CHALLENGES: Anaesthesia for dental and oral procedures in cats can be challenging and many factors need to be taken into consideration. Often it is older patients requiring these procedures and, while old age itself is not a contraindication for general anaesthesia, older patients tend to have limited homeostatic reserves and are, therefore, more prone to anaesthesia-induced insults of vital organs. Most sedative and anaesthetic agents have cardiovascular side effects, which may result in detrimental consequences in older patients in which organ reserves are likely reduced...
January 2015: Journal of Feline Medicine and Surgery
Eduardo Cordioli
BACKGROUND: Enthusiasts suggest that labouring in water and waterbirth increase maternal relaxation, reduce analgesia requirements and promote a midwifery model of care. Critics cite the risk of neonatal water inhalation and maternal/neonatal infection. OBJECTIVES: To assess the evidence from randomised controlled trials about immersion in water during labour and waterbirth on maternal, fetal, neonatal and caregiver outcomes. METHODS: HASH(0x3374e48) SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2011) and reference lists of retrieved studies...
2013: São Paulo Medical Journal, Revista Paulista de Medicina
André Börgers, Violeta Brunkhorst, Harald Groeben
Because of excellent results, high patient satisfaction, and extraordinary surgical conditions robotic assisted prostatectomies have found a wide spread acceptance. Trendelenburg positioning, CO2-Insufflation, and installation of the robot system cause moderate hemodynamic and respiratory changes. Respiration can be compromised by significantly reduced pulmonary compliance during surgery and a marked CO2 load. Therefore, arterial blood gas controls during surgery can be recommended. Over hours edema of head and neck including the upper airways and an increase of the intraocular pressure can develop...
July 2013: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Madhuri S Kurdi, Tushar Patel
Melatonin is a neurohormone secreted by the pineal gland. It is widely present in both plant and animal sources. In several countries, it is sold over the counter as tablets and as food supplement or additive. Currently, it is most often used to prevent jet lag and to induce sleep. It has been and is being used in several clinical trials with different therapeutic approaches. It has sedative, analgesic, anti-inflammatory, anti-oxidative and chronobiotic effects. In the present review, the potential therapeutic benefits of melatonin in anaesthesia and critical care are presented...
March 2013: Indian Journal of Anaesthesia
M D Scarlett, A Crawford-Sykes, H E Harding, D R Chen
The one-year Diploma in Anaesthetics (DA) was the first postgraduate programme offered by the then Faculty of Medicine of The University of the West Indies (UWI). It was instituted in 1966, when the need for trained physician anaesthetists became paramount. Over 200 physicians have been awarded the DA which was discontinued in 1994. The four-year Doctor of Medicine in Anaesthetics [DM (Anaesthetics)] was commenced in 1974 and continues to train most of the region's physician anaesthetists. The majority of the 119 graduates (as of December 2011) are providing invaluable services to the people of the Caribbean...
July 2012: West Indian Medical Journal
L Beydon, C Pelluchon, S Beloucif, H Baghdadi, A Baumann, J-E Bazin, P Bizouarn, S Crozier, B Devalois, B Eon, F Fieux, C Frot, E Gisquet, C Guibet Lafaye, N Kentish-Barnes, O Muzard, A Nicolas-Robin, M O Lopez, F Roussin, L Puybasset
CONTEXT: Management of the end of life is a major social issue which was addressed in France by law, on April 22nd 2005. Nevertheless, a debate has emerged within French society about the legalization of euthanasia and/or assisted suicide (E/AS). This issue raises questions for doctors and most especially for anesthetists and intensive care physicians. OBJECTIVE: To highlight, dispassionately and without dogmatism, key points taken from the published literature and the experience of countries which have legislated for E/AS...
September 2012: Annales Françaises D'anesthèsie et de Rèanimation
Robert Gaiser
The specialty of anaesthesiology has expanded from the intra-operative management of the surgical patient undergoing an operative procedure to the perioperative management of patients undergoing procedures. The perioperative management involves the preoperative evaluation and preparation and also involves the postoperative management of the patient. To effectively perform these functions, a solid foundation in cardiology, pulmonary Medicine, critical care Medicine and pain medicine is mandatory. After completing the required courses in medical school, electives in these areas will prepare the student for further training in anaesthesiology...
March 2012: Best Practice & Research. Clinical Anaesthesiology
N Hoffmann, G Breuer, J Schüttler, A E Goetz, G N Schmidt
BACKGROUND: In 2003 anaesthesiology was implemented as a compulsory speciality of undergraduate teaching in Germany due to the revised regulations of medical education. Besides the preexisting subject of emergency medicine an obligatory course in anaesthesiology was introduced. Thus anaesthesiology has gained considerable importance in all medical faculties. To gain insight into the current status of undergraduate medical education in the university departments of anaesthesiology a nationwide survey at all university departments in Germany was initiated...
March 2012: Der Anaesthesist
A Sáez Fernández, J M Sistac Ballarín, F Martínez Torrente, J M Calvo Vecino, M Olmos Rodríguez
The recent publication of guidelines for postgraduate training in anesthesiology, pain, and intensive care issued by the European Board of Anaesthesia (EBA) and the European Union of Medical Specialists (UEMS) ( specifies directions we must take with our residents. The training section of the Sociedad Española de Anestesiología y Reanimación (SEDAR) has decided to make the guidelines available on the association's website so that the UEMS/EBA proposals can be compared to the training program drafted by the Spanish national board for our specialty...
August 2011: Revista Española de Anestesiología y Reanimación
Alexander Schleppers, Thomas Prien, Hugo Van Aken
For years now, the German Society of Anaesthesiology and Intensive Care Medicine and the Professional Association of German Anaesthesiologists have been actively involved in efforts to improve patient safety. To this end, a whole range of activities have been initiated in recent years and, since February 2011, collected together on our home page 'PATSI' ( Further, the implementation of syringe labelling (ISO 26825) with additional information on drugs frequently used in intensive care was carried out...
June 2011: Best Practice & Research. Clinical Anaesthesiology
Roman Schumann
Although many smaller studies have addressed anaesthetic care for bariatric surgical patients, comprehensive systematic literature reviews have yet to be compiled, and much evidence includes expert panel opinion. This review summarises study results in bariatric surgical patients regarding pre-anaesthesia evaluation, the perioperative impact of sleep-disordered breathing, airway management at anaesthetic induction and emergence, maintenance of anaesthesia, postoperative pain management, utility of clinical-care pathways and feasibility of outpatient bariatric surgery...
March 2011: Best Practice & Research. Clinical Anaesthesiology
S Heinrich, T Horbach, D Salleck, T Birkholz, A Irouschek, J Schmidt
BACKGROUND: In the long run, surgical treatment proves to the most effective measure for the treatment of both morbid adipositas and concomitant morbidity. Patients undergoing bariatric surgical procedures are a challenge to the anaesthesiologist: Obesity-associated morbidity, the potentially difficult airway and intravenous accesses as well as the demand for effective pain and anti-emetic therapy. Interrestingly, only sparse and conflicting data exist about the perioperative anaesthesiological management of these patients...
December 2011: Zentralblatt Für Chirurgie
S K Mathur, S K Dube, Sunil Jain
Anaesthesiologists are playing a decisive role in patient management. Present day anaesthesiology is based on the use of newer and safer drugs, better patient monitoring, pain management and critical care. But the general public knows little of these developments. The study was undertaken to assess the perception regarding the anaesthesiology and anaesthesiologists among the general population. The present study was conducted on 300 persons (patient, patient's attendant and medical undergraduates) between 18-75 years of age to assess the knowledge regarding anaesthesiology and the anaesthesiologists...
April 2009: Indian Journal of Anaesthesia
Paolo Pelosi, Cesare Gregoretti
Obesity is a metabolic disease that is on the increase all over the world. Up to 35% of the population in North America and 15-20% in Europe can be considered obese. Since these patients are characterised by several systemic physiopathological alterations, the perioperative management may present some problems, mainly related to their respiratory system. Body mass is an important determinant of respiratory function before and during anaesthesia not only in morbidly but also in moderately obese patients. These can manifest as (a) reduced lung volume with increased atelectasis; (b)derangements in respiratory system, lung and chest wall compliance and increased resistance; and (c) moderate to severe hypoxaemia...
June 2010: Best Practice & Research. Clinical Anaesthesiology
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