Turkish journal of anaesthesiology and reanimation
-
Turk J Anaesthesiol Reanim · Jun 2020
ReviewStaying Ahead of the Curve: Modified Approach to Emergency Caesarean Section Under General Anaesthesia in COVID-19 Pandemic.
The recent outbreak of SARS-CoV-2 has prompted healthcare professionals to re-design and modify the standards of care and operating procedures relevant to dealing with suspected or confirmed cases of COVID-19. The aim of this review is to highlight the key recommendations related to obstetric anaesthesia from scientific bodies in the United Kingdom and United States and to summarize recently developed and implemented clinical pathways for care of obstetric patients - specifically those requiring urgent general anaesthesia for caesarean section within a large maternity unit in London. ⋯ In these settings, emphasis needs to be put on meticulous preparation, safety checklists and specific equipment and staffing adjustments. We present a structured framework comprised of four critical steps aimed to facilitate the development of local strategies and protocols.
-
Turk J Anaesthesiol Reanim · Jun 2020
ReviewPerioperative Anaesthetic Management of Confirmed or Suspected COVID-19 Patients.
The outbreak of coronavirus disease (COVID-19) that started in Wuhan, China, has spread to 210 countries, infecting 2,726,274 patients and causing 191,075 deaths by April 24, 2020, and has turned into a global threat. Although various measures have been taken to stop human-to-human transmission in many countries, health care workers are in the high-risk zone for transmission as they deliver patient care. ⋯ Anaesthesia management of patients with COVID-19 also is a challenge for anaesthesiologists as it is an infection that may affect not only the respiratory system but also other vital organs. The aims of this review are to provide prudent safety measures to protect anaesthesiologists and other health care workers in the operating theatre and recommendations or the safest anaesthesia management of patients with suspected or confirmed COVID-19 undergoing surgery.
-
Turk J Anaesthesiol Reanim · Jun 2020
Association between Blood Pressure after Haemodynamic Resuscitation in the Prehospital Setting and 28-Day Mortality in Septic Shock.
Septic shock results in a decreased blood pressure (BP) leading to organ failure. The haemodynamic resuscitation aims at restoring the BP to allow efficient tissue perfusion. The aim of the present study was to evaluate the association between the mean BP (MBP) reached after haemodynamic resuscitation in patients with septic shock cared for in the prehospital setting by a mobile intensive care unit (MICU) and mortality at 28 days after intensive care unit (ICU) admission. ⋯ Persistent low MBP after prehospital initial resuscitation measures in patients with septic shock managed in the prehospital setting is associated with increased mortality. Further studies are needed to evaluate the impact of prehospital haemodynamic management in septic shock to further optimise prehospital care and improve outcome.
-
Turk J Anaesthesiol Reanim · Apr 2020
The Effect of Tranexamic Acid Administration on Perioperative Bleeding in Patients Undergoing Knee or Hip Arthroplasty: A Single-Centre Retrospective Study.
Tranexamic acid (TXA) has been used to reduce perioperative bleeding in various surgeries because of its antifibrinolytic effect. Recently, patients undergoing orthopaedic surgery in our institution received a loading dose of TXA (10 00 mg) before surgery, followed by 100 mg h-1 until the end of surgery. The purpose of the present study was to evaluate the efficacy of TXA administration on the perioperative blood loss in patients undergoing knee arthroplasty or hip arthroplasty. ⋯ The administration of TXA (loading dose of 1000 mg and continuous infusion of 100 mg h-1) reduced postoperative transfusion and perioperative blood loss. These results indicated that TXA administration is useful for reducing perioperative blood loss in patients undergoing knee or hip arthroplasty.
-
Turk J Anaesthesiol Reanim · Apr 2020
ReviewPostoperative Nausea and Vomiting in Paediatric Anaesthesia.
Postoperative nausea and vomiting (PONV) is a common complication in paediatric anaesthesia and is a source of significant morbidity. Various independent risk factors have been implicated in the development of paediatric PONV, including higher pain scores postoperatively, the use of opioids for pain management and the use of volatile anaesthetics for the maintenance of anaesthesia. This review of the current literature regarding the prevention and treatment of paediatric PONV is based on a search of the PubMed database, which identified published clinical trials, systematic reviews and meta-analyses. ⋯ Frequently administered drug classes for the prevention of PONV include corticosteroids, 5HT3 antagonists and anticholinergics. The clinical use of the findings in the literature may help to reduce the occurrence of PONV in children. In this review, we provide comprehensive and updated information on the risk factors contributing the occurrence of PONV in children, outline the current opinion on the drugs that are commonly used for management and provide an overview of the guidelines that are used to help establish the prophylaxis and treatment of paediatric PONV.