Current opinion in anaesthesiology
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The aim of this review is to give a general overview of anesthetic management, technical considerations and specific complications of interventional neuroradiology based on the most recent literature. ⋯ Interventional neuroradiology is challenging because of the location and the sudden and acutely life-threatening complications that may occur.
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Curr Opin Anaesthesiol · Aug 2003
Challenges facing the anesthesiologist in the emergency department.
This review focuses on developments in airway management and concious sedation/analgesic techniques employed by anesthesiologists in the emergency department. ⋯ The consultant anesthesiologist responding to a critical airway may face a variety of challenges, including traumatized or soiled airways, patients with cervical spine fractures, and patients who have undergone sedation techniques that may have progressed to deep and general anesthesia. Anesthesiologists may also face the challenge of responding to these emergent situations without all the equipment or adequately trained support staff necessary to handle those emergencies safely.
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Curr Opin Anaesthesiol · Aug 2003
Brachial plexus blocks: infusions and other mechanisms to provide prolonged analgesia.
Regional anesthesia has numerous benefits for upper extremity surgery such as improved analgesia, opioid sparing and reduced side effects. However, many of these advantages are lost after block regression. Recently, several strategies such as continuous ambulatory local anesthetic infusions and adjuvants that may potentiate analgesia after a brachial plexus block have been described and investigated. This review will highlight and place in context this recent work. ⋯ The advances and techniques recently described demonstrate that prolonging analgesia after brachial plexus blocks is possible. This may be accomplished via several different approaches and mechanisms resulting in improved patient analgesia and side effects.
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The elderly population is increasing in number each year, and more patients are presenting for anesthesia and surgery. One of the key areas for improving the care of the elderly is a better understanding of the influence of aging on drug pharmacokinetics and dynamics. ⋯ The effects of comorbidity and intercurrent medications may alter the normal anesthetic practice of the clinician's care of the elderly patient. Further studies in these key areas may lead to improved outcomes.
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The practice of office-based anesthesia is quickly emerging as an important field for the anesthesia provider. The number of procedures being done in offices around the country has steadily increased, as has the invasiveness of these procedures. This creates new anesthetic considerations. To date most training programs have not addressed this area of practice. As practitioners enter the field, however, they should have information as to how to provide quality care in a location where very often they are completely alone. Many of the safety mechanisms we as anesthesia providers take for granted in a hospital setting are often not present in a surgical office, and it becomes our responsibility to help in establishing standards. ⋯ As office-based anesthesia continues to mature as a specialty, we the anesthesia providers must be proactive in establishing guidelines and recommendations to make the practice safe. We should be informed of the rules and regulations that exist in our states, and we should provide a voice for the patients who put their faith in us.