Current opinion in anaesthesiology
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To evaluate the most recent publications in the long-lived debate over the use of etomidate in critically ill septic and trauma patients. ⋯ A single dose of etomidate supplies good intubation conditions with hemodynamic stability, but increases the risk for adrenal insufficiency. The relative importance of these characteristics for the patients' outcome remains controversial, as there is a lack of direct evidence. According to the principle 'nihil nocere', reasoning argues against its use, especially in septic patients or in those at major risk to develop septic complications (e.g. trauma patients).
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Curr Opin Anaesthesiol · Aug 2013
ReviewInterventional radiology in the pregnant patient for obstetric and nonobstetric indications: organizational, anesthetic, and procedural issues.
As indications for interventional radiology procedures during pregnancy continue to expand, anesthesiologists must be aware of the indications for specific procedures as well as provide the safest possible anesthetic care to both the mother and the fetus in nontraditional environments. ⋯ The risk to the fetus of the imaging procedure must be weighed against the benefit to the mother of early and accurate diagnosis and treatment of the underlying pathology. As the organizational aspects of providing care become more complex, simulation, guidelines, and protocols may become important to the safe care of these patients.
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Curr Opin Anaesthesiol · Aug 2013
ReviewStandard approaches for upper extremity nerve blocks with an emphasis on outpatient surgery.
Currently, no standards exist with regard to the techniques and administration of ultrasound-guided peripheral nerve blocks. Consequently, the techniques and teaching substantially vary among practitioners and institutions. The purpose of this review is to propose a set of standard US-guided techniques for upper extremity nerve blocks. ⋯ A set of structured recommendations and approaches are suggested to help standardize clinical practice and teaching of ultrasound-guided upper extremity nerve blocks. Additional emphasis is placed on the discussion of nerve blocks in outpatient surgery.