Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Dec 2008
ReviewThe measurement of dyshemoglobins and total hemoglobin by pulse oximetry.
Recent advances in pulse oximetry have made it possible to noninvasively measure total hemoglobin, as well as the two most common dyshemoglobins. This review will trace the development and clinical application of multiwavelength pulse oximetry. ⋯ The development of multiwavelength pulse oximeters, which can measure total hemoglobin as well as dyshemoglobins, should result in improved patient care.
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Curr Opin Anaesthesiol · Dec 2008
ReviewManagement of outcomes in the ambulatory surgery center: the role of standard work and evidence-based medicine.
Quality and safety in the manufacturing and airline industries have benefited from evidenced-based process-improvement strategies. This review investigates the rationale for application of these same processes in the ambulatory anesthesia setting. ⋯ Ambulatory surgery and anesthesia care is uniquely oriented to the application of repetitive processes in the provision of highly predictable and reproducible surgical services. Ambulatory anesthesiologists should lead the healthcare industry in the much wider adoption of standard practice protocols and team training to maximally improve the safety and quality of patients' experiences.
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Curr Opin Anaesthesiol · Dec 2008
ReviewReview of video laryngoscopy and rigid fiberoptic laryngoscopy.
Recent advances in fiberoptic systems and video technology have resulted in the development of new intubation devices and techniques. A defining characteristic of rigid fiberoptic and videolaryngoscopic techniques is that glottic opening is viewed indirectly in place of direct line-of-sight. Various issues common to all instruments in this group are highlighted, and a few recently released tools are described. The aim of this article is to review material published since January 2007. ⋯ As indirect laryngoscopic tools become more available, and clinicians become more facile in their use, the management of (potentially) difficult intubations is likely to change. Further technological advances are likely to lead to the development of even more new instruments.
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Curr Opin Anaesthesiol · Dec 2008
ReviewRegional anesthesia techniques for ambulatory orthopedic surgery.
The purpose of this review is to present advances in the use of regional anesthetic techniques in ambulatory orthopedic surgery. New findings regarding the use of both neuraxial anesthesia and peripheral nerve block are discussed. ⋯ In summary, shorter acting, neuraxial, local anesthetic agents, specific to the expected duration of surgery, may provide superior recovery profiles in the ambulatory setting. A trend towards more peripheral and selective nerve blocks exists. The infrapatellar block is a promising technique to provide analgesia following knee arthroscopy. Improved analgesia seen in the perioperative period can be safely and effectively extended to the postoperative period with the use of perineural catheters.