Current opinion in anaesthesiology
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Human immunodeficiency virus (HIV) infection is one of the major global health problems. Because the advances in treatment of HIV infection increase the patient's survival, anaesthesiologists may care for these patients during their practice. This article highlights HIV infection and anaesthetic implications. ⋯ Anaesthesia in HIV-infected patients should be individualized and depend on the status of the patient.
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The purpose of this review is to discuss the risk factors associated with laryngospasm and the techniques used for prevention and treatment. We also summarize the prevention and treatment modalities in organized algorithms. ⋯ Identifying the risk factors and taking the necessary precautions are the key points in prevention of laryngospasm. An experienced anesthesiologist is associated with lower incidence of laryngospasm. Airway management is the most essential part of treatment of laryngospasm. Drugs can be used as an adjunct in treatment of laryngospasm, especially when anesthesia is administered by beginners.
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Curr Opin Anaesthesiol · Jun 2009
ReviewPresent and emerging strategies for reducing anesthesia-related maternal morbidity and mortality.
As the demographic of pregnant women continues to change, anesthesiologists will need to continue to find new ways to prevent morbidity and mortality. In this article several new and emerging strategies to meet this challenge are discussed. ⋯ Over the past 50 years, the field of anesthesiology has reduced the rates of anesthesia-related maternal mortality and major morbidity considerably. As the obstetric demographic becomes older and more obese, new technologies and strategies can assist in keeping maternal death and major morbidity vanishingly rare.
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Curr Opin Anaesthesiol · Jun 2009
ReviewAnaesthetic issues in women undergoing gynaecological cytoreductive surgery.
Increasing numbers of women with ovarian cancer are undergoing cytoreductive surgery in reference centres. This review looks at this disease in these women and the different aspects of perioperative clinical management of these patients by the anaesthetic team: preoperative screening, anaesthetic techniques, fluid or blood management or both and prevention and treatment of important complications. ⋯ Anaesthesia is more than 'keeping asleep'. Anaesthesiologists have an enormous responsibility in the preoperative, peroperative, and postoperative period for patients undergoing gynaecological cytoreductive surgery.
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Curr Opin Anaesthesiol · Jun 2009
ReviewEffect of head posture on pediatric oropharyngeal structures: implications for airway management in infants and children.
Although head and neck posture has direct effects on the upper airway in infants and children, many of these effects remain unclear or not well established. As airway patency and airway access are critical in sedated and/or unconscious children, recent developments in this area should be made known to pediatric anesthesiologists, intensive care physicians and other emergency caregivers. ⋯ The site of obstruction of the airway in sedated children in different postures is now more clear. Implications of head flexion and extension in intubated children have been extensively studied, and clinical consequences have been detailed. Due to large interindividual anatomic variability, depth marks set on the tubes by their manufacturers and guidelines regarding calculations of insertion depth should be made with caution in infants and neonates. Despite several studies, there is still little scientific evidence regarding proper head posture for laryngoscopy and intubation.