Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Aug 2005
Anaesthetics and the rate corrected interval: learning from droperidol?
Understanding of the long QT syndrome continues to evolve. Anaesthesia in patients with untreated long QT syndrome carries a risk of perioperative malignant ventricular arrhythmias. Genotypically susceptible individuals may have a normal rate-corrected QT interval and present with torsade de pointes intraoperatively. The likelihood of arrhythmias can be reduced by careful preoperative preparation. Perioperative disturbances in physiological homeostasis and drugs administered can prolong the rate-corrected QT interval. ⋯ Droperidol can lead to serious cardiac arrhythmias from QT prolongation. Recent advances in the pathophysiology of congenital and acquired long QT syndrome are reviewed. Preclinical tests assessing potential new drugs for QT prolongation are briefly discussed. Considerations for the management of these patients during perioperative phases are explored. The optimal treatment of the long QT syndrome is presented along with a glimpse into future possibilities in this field.
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Curr Opin Anaesthesiol · Aug 2005
Pediatric sedation outside the operating room: the year in review.
This review is a survey of the recent literature concerning issues and trends in the rapidly changing field of pediatric sedation. ⋯ The evolution of systems, drugs, and monitors for the provision of pediatric sedation is continuing. An accurate assessment of safety and other outcomes will be enhanced through the establishment of multicenter collaborative databases.