Current opinion in anaesthesiology
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Nonoperating-room anesthesia includes sedation or anesthesia for radiological imaging, cardiac catheterization, office-based surgery, and pediatric procedures or investigations, all of which have seen explosive growth over the last decade. This review discusses the factors that are driving this growth and the challenges we face as a profession to accommodate new practice paradigms. ⋯ Nonoperating-room anesthesia will play a central role in anesthesia practice in the future. Provision of these services requires planning, personnel, and institutional resources. This should be a high priority for anesthesiology departments to ensure delivery of the highest quality of patient care in a cost-effective and organized manner.
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Curr Opin Anaesthesiol · Aug 2006
ReviewPropofol infusion syndrome in anaesthesia and intensive care medicine.
Propofol infusion syndrome is a rare but often fatal syndrome, characterized by lactacidosis, lipaemic plasma and cardiac failure, associated with propofol infusion over prolonged periods of time. As propofol is used worldwide, knowledge of propofol infusion syndrome is essential for all anaesthesiologists and intensive care physicians. This review will provide an update on reported cases, and describe recent findings relevant to the pathophysiology and clinical presentation of propofol infusion syndrome. ⋯ Propofol infusion syndrome must be kept in mind as a rare but highly lethal complication of propofol use, not necessarily confined to the prolonged use of propofol. Dose limitations must be adhered to, and early warning signs such as lactacidosis should lead to the immediate cessation of propofol infusion.
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Curr Opin Anaesthesiol · Aug 2006
ReviewBeneficial effects of statins on perioperative cardiovascular outcome.
This review evaluates clinical and experimental articles that have recently been published on the cardioprotective effect of perioperative statin therapy. ⋯ Perioperative statin therapy may stabilize coronary plaques due to pleiotropic effects and results in a reduction of perioperative cardiovascular complications.
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Curr Opin Anaesthesiol · Aug 2006
ReviewStaffing and case scheduling for anesthesia in geographically dispersed locations outside of operating rooms.
Scheduling and staffing for anesthetics outside of the operating room that are geographically dispersed is different than for operating room cases. Whereas methods to predict how long such cases take were published recently, this article reviews staffing and case scheduling. ⋯ Plan staffing based on providing open access to anesthesia time within a reasonable number of days (e.g., 2 weeks). Schedule cases and release allocated time based on reducing overutilized anesthesia time.