Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Oct 2014
ReviewAnesthesia for intracranial surgery in infants and children.
Age-related differences in the surgical lesions, anatomy and physiological responses to surgery and anesthesia underlie the clinically relevant differences between pediatric patients and their adult counterparts. Anesthesiologists need to be aware of the unique challenges in the anesthetic management of the pediatric neurosurgical patient. ⋯ The aim of this review is to highlight the impact of these techniques on the intraoperative management of the pediatric neurosurgical patient. These issues are essential in minimizing perioperative morbidity and mortality.
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To explore the recent advances in the use of ultrasound for lower extremity blocks, including approaches to the lumbar and sacral plexus blocks. ⋯ Lower extremity blocks under ultrasound guidance often require advanced skills because of the depth of target nerves. This review summarizes the recent advances in the use of ultrasound guidance over traditional techniques.
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Curr Opin Anaesthesiol · Oct 2014
ReviewWhat's new in the management of traumatic brain injury on neuro ICU?
In recent years, we have begun to better understand how to monitor the injured brain, look for less common complications and importantly, reduce unnecessary and potentially harmful intervention. However, the lack of consensus regarding triggers for intervention, best neuromonitoring techniques and standardization of therapeutic approach is in need of more careful study. This review covers the most recent evidence within this exciting and dynamic field. ⋯ Neurocritical care management of traumatic brain injury continues to evolve. However, it is important not to use a 'one-treatment-fits-all' approach, and perhaps look to use targeted therapies to individualize treatment.
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Robots in regional anesthesia are used as a tool to automate the performance of regional techniques reducing the anesthesiologist's workload and improving patient care. The purpose of this review is to show the latest findings in robotic regional anesthesia. ⋯ Robots can improve the performance and safety in regional anesthesia. In this review, we present the developments made in robotic and automated regional anesthesia, and discuss the current state of research in this field.
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Curr Opin Anaesthesiol · Oct 2014
ReviewRegional anesthesia in patients with pre-existing neurologic disease.
Regional anesthesia is controversial in patients with pre-existing neurologic disease. This study reviews the published evidence regarding the utilization and outcomes of regional anesthetics in this population. ⋯ Regional anesthesia can be safely utilized in patients with pre-existing neurological disease and may have benefits over general anesthesia; however, a conservative approach is warranted. In addition, further publications regarding regional techniques in this population are needed.