Current opinion in anaesthesiology
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Targeted intrathecal drug delivery systems (IDDS) are an option in algorithms for the treatment of patients with moderate-to-severe chronic refractory pain. This article is intended to review the literature regarding IDDS published over the last year, with special attention to the Polyanalgesic Consensus Conference 2012. ⋯ This review includes the recommendations for the use of IDDS, trialing, and recent reports of complications (especially, the occurrence of granulomas). In addition, the latest documents on cerebrospinal fluid and potential lines of future development are discussed.
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Curr Opin Anaesthesiol · Oct 2013
ReviewUltrasound guidance, a win-win approach to peripheral nerve blockade.
The objective of the current review is to examine the likelihood of improved safety in peripheral nerve blockade attributable to ultrasound guidance. ⋯ Ultrasound is clearly superior to other techniques with the aim of achieving maximum efficacy with minimum risk: a win-win approach.
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Curr Opin Anaesthesiol · Oct 2013
ReviewTranscranial doppler and near infrared spectroscopy in the perioperative period.
Maintenance of adequate blood flow and oxygen to the brain is one of the principal endpoints of all surgery and anesthesia. During operations in general anesthesia, however, the brain is at particular risk for silent ischemia. Despite this risk, the brain still remains one of the last monitored organs in clincial anesthesiology. ⋯ TCD and NIRS are noninvasive monitors that anesthesiologists apply to tailor cerebral oxygen delivery, aiming to safeguard brain function in the perioperative period.
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This article reviews the current state of knowledge in functional MRI (fMRI) research related to pain with primary focus on clinical studies. ⋯ As we learn more about fMRI related to pain, functional connectivity patterns could emerge as biomarkers for specific pain conditions.
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Curr Opin Anaesthesiol · Oct 2013
ReviewThe new technological trends in ultrasound-guided regional anesthesia.
Real-time two-dimensional ultrasound guidance is undoubtedly one of the most important evolutions in the field of regional anesthesia techniques, for peripheral nerve blocks and neuraxial anesthesia. The recent literature has been analyzed for studies concerning new technological trends in ultrasound-guided regional anesthesia. This review focuses on electromagnetic tracking systems for ultrasound guidance and three/four-dimensional ultrasound imaging in regional anesthesia. ⋯ This article describes the principles, technology and development of electromagnetic tracking system for ultrasound guidance and three/four-dimensional ultrasound imaging in regional anesthesia, considering whether these new technologies will have impending applications in clinical practice.