Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Aug 2014
ReviewManagement of anaesthetic emergencies and complications outside the operating room.
Anesthesia outside the operating room is commonly uncomfortable and risky. In this setting, anesthetic emergencies or complications may occur. This review aims to report the most recent updates regarding the management of prehospital anesthesia, anesthesia in the trauma and emergency rooms, and anesthesia for endoscopy and interventional radiology. ⋯ Anesthesia outside the operating room requires careful monitoring to avoid side-effects and education of nonanaesthetists when they are involved. A useful tool is to continuously improve the protocols and checklists to make anesthesia in this setting safer.
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Curr Opin Anaesthesiol · Aug 2014
ReviewScheduling for anesthesia at geographic locations remote from the operating room.
Providing general anesthesia at locations away from the operating room, called remote locations, poses many medical and scheduling challenges. This review discusses how to schedule procedures at remote locations to maximize anesthesia productivity (see Video, Supplemental Digital Content 1). ⋯ Remote locations with sufficient hours of cases should be allocated time reserved especially for them in which to schedule their cases, with a maximum waiting time of 2 weeks, to achieve an average wait of 1 week.
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Curr Opin Anaesthesiol · Aug 2014
ReviewAnesthesia in neurologic and psychiatric diseases: is there a 'best anesthesia' for certain diseases?
Patients with diseases affecting the central nervous system present a wide range of clinical manifestations increasing the perioperative risk. The following review focused on recommendations for anaesthesiological management in patients with both neurologic and psychiatric diseases. ⋯ The 'best' anesthesia includes adequate preoperative evaluation of the individual risk, optimization of comorbidities before elective surgery, the use of short-acting anesthetic agents for induction and maintenance of general anesthesia, avoidance of volatile agents and succinylcholine in muscular dystrophy and myopathies.
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Curr Opin Anaesthesiol · Aug 2014
ReviewSystemic lidocaine in surgical procedures: effects beyond sodium channel blockade.
This review presents current data on the systemic administration of lidocaine. The focus is on studies in the perioperative setting. In addition, there is a brief look at experimental data on the effect of lidocaine at the molecular level. ⋯ Positive effects on postoperative pain, as well as on bowel motility and hospital discharge time, have regularly been observed. However, contradictory findings have also been published. As almost all of the studies only include very small patient numbers, large multicenter investigations are needed.
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Curr Opin Anaesthesiol · Aug 2014
ReviewImportant issues for perioperative systemic antimicrobial prophylaxis in surgery.
Prevention of surgical site infections is a key issue to patient safety and the success of surgical interventions. Systemic antimicrobial prophylaxis is one important component of a perioperative infection prevention bundle. This review focuses on selected recent developments and important concepts in the field. ⋯ Most frequently, anaesthesiologists administer perioperative antimicrobial prophylaxis. Identification of core principles and harmonization of protocols should facilitate this task and thus help to improve patient safety and to monitor compliance. However, local and regional epidemiology have to be taken into account in order to establish local protocols.