Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Dec 2012
ReviewNausea and vomiting after surgery: it is not just postoperative.
The purpose of this review is to highlight postoperative nausea and vomiting (PONV), to discuss why it occurs, how it might be prevented and then how it can be treated. ⋯ It is easy to turn the vapourizer dial, but that is a part of the problem. Not everyone reacts the same to drugs. Although PDNV is not as well characterized as PONV, at the very least, avoid an anaesthetic that may make PONV/PDNV worse and be aggressive in treating the problem.
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Curr Opin Anaesthesiol · Dec 2012
ReviewIntroduction of evidence-based medicine in undergraduate medical curriculum for development of professional competencies in medical students.
Current undergraduate medical curricula in most institutions around the globe do not nurture the skills, needed for self-directed lifelong learning in medical graduates, and it needs to be reformed in such a way that the medical graduate who is trained through this reformed curriculum, possesses all the competencies of a self-directed learner. Evidence-based medicine (EBM), a new vision of physician learning which is based on continuous development and assessment of competencies needed for creating self-directed learners is to be strongly advocated for inclusion in the undergraduate medical curriculum. ⋯ Introduction of EBM in undergraduate medical curriculum helps in the development of professional competencies of self-directed learners in medical students.
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Office-based anesthesia is a new and growing subspecialty within ambulatory anesthesia. We examine major developments in office-based anesthesia and how patient safety can be maintained. ⋯ There is no uniform standard of care for performing procedures in the office-based setting. Healthcare providers are facing the challenge of creating a safer, efficient, cost-effective and patient-centered environment. Available data show that the office-based practice can be as safe as any ambulatory surgicenter or hospital, as long as patients, regulators, and physicians become educated advocates of safer practices. In addition, procedures can be performed safely with general anesthesia or conscious sedation, provided that there are properly trained personnel and adequate equipment and facilities. Moreover, physicians should be credentialed to perform the same procedure in a hospital that they perform in an office.
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Curr Opin Anaesthesiol · Dec 2012
Review Historical ArticleHistory of anesthesia for ambulatory surgery.
Anesthesia for ambulatory surgery has come a long way since 1842 when James Venable underwent surgery for removal of a neck mass with Crawford W. Long administering ether and also being the surgeon. We examine major advances over the past century and a half. ⋯ Beyond the discovery in the mid-19th century that ether and nitrous oxide could be used to render patients unconscious during surgical procedures, subsequent developments in our specialty have added modestly, in a stepwise manner, to reduce mortality and morbidity associated with its use. These improvements have allowed us to safely meet the steadily increasing demand for ambulatory surgery.