Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Jun 2008
ReviewNeuromuscular and mitochondrial disorders: what is relevant to the anaesthesiologist?
The review provides an up-to-date information to the anaesthesiologist about the more frequent and important neuromuscular disorders for which new basic insights or clinical implications have been reported. ⋯ The increased understanding of the genetics and pathophysiology of common muscle disorders may lead to a decrease in life-threatening complications related to surgery and anaesthesia. However, there is still a lack of prospective clinical studies to determine which is the safest anaesthetic technique for these patients.
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Curr Opin Anaesthesiol · Jun 2008
ReviewPostoperative complications in elderly patients and their significance for long-term prognosis.
To outline perioperative risk factors for postoperative mortality in older patients, the relationship of these factors with long-term mortality, and to examine possible strategies to reduce mortality. ⋯ Strategies are needed to prevent, or at least adequately manage, complications in elderly patients. Agreed international definitions for risks and complications can help in assessing risks and benefits.
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The present study summarizes the knowledge to date of the use of remifentanil in obstetric anaesthesia and analgesia. ⋯ Remifentanil has a place in obstetric anaesthesia and analgesia. Further studies are needed to confirm if background infusions are safe in addition to patient-controlled analgesia. Studies are needed to establish a dose range under general anaesthesia that prevents neonatal respiratory depression at birth.
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Curr Opin Anaesthesiol · Jun 2008
ReviewEpidemiology and morbidity of regional anaesthesia in children.
To evaluate which techniques of regional anaesthesia are made in 2008 and to appreciate and check their safety. ⋯ Regional anaesthesia is very much used in the child and develops very quickly. The peripheral accesses represent the majority of the regional techniques used. Continuous injection, after central or peripheral accesses, also progresses. There are complications in podiatry after regional anaesthesias. In most cases, they are not serious permanent problems, but they are probably underestimated. Modern approaches of treatment for the nervous structures (neurostimulators and echographs) are available and are used more often in order to increase the effectiveness. Careful use of the neurostimulator and ultrasonography may probably improve the safety in paediatric regional anaesthesia in the years to come.
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We aimed to review the current clinical status and advances in endoscopic and open surgical interventions on the fetus in terms of indications, technical aspects and reported outcomes. ⋯ Fetal surgery seems safe and has therefore become a clinical reality. With the current state of technology, open and endoscopic interventions do not compete, each having their indications. Although the stage of technical experimentation is over, most interventions remain investigational. Inclusion of patients into trials whenever possible should be encouraged rather than building up casuistic experience. Healthcare providers and individual centers should be encouraged to consider viability and efficacy of new treatment programs.