Current opinion in anaesthesiology
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Mentoring is fundamentally valuable and important to students considering a path into our specialty, as well as to colleagues already in it and with ambition to advance. General principles and personal experiences are collected and described to help inform future mentors and to reinforce the value of having a mentor and the satisfaction (and work) that is associated with such a role. ⋯ Access to a mentor is an often-cited key to choosing a specialty and the success of junior colleagues and thus the entire department. Mentoring is fundamentally valuable in providing role modeling and also in protecting the mentee from the inefficiency of learning lessons the hard way.
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Measuring clinically relevant and patient-centered perioperative outcomes provides the knowledge that enables clinicians to optimize their practice and guide shared decision-making, researchers to set a future agenda and policymakers to prioritize healthcare spending. ⋯ Future clinical trials in perioperative medicine should utilize clearly defined, validated and standardized patient-centered outcome measures.
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Curr Opin Anaesthesiol · Dec 2016
ReviewAnaesthesia in outer space: the ultimate ambulatory setting?
Missions to the Moon or more distant planets are planned in the next future, and will push back the limits of our experience in providing medical support in remote environments. Medical preparedness is ongoing, and involves planning for emergency surgical interventions and anaesthetic procedures. This review will summarize what principles of ambulatory anaesthesia on Earth could benefit the environment of a space mission with its unique constraints. ⋯ The application of some of the key principles of ambulatory anaesthesia, as well as recent advances in anaesthetic techniques and better understanding of human adaptation to the space environment might allow nonanaesthesiologist physicians to perform common anaesthetic procedures, whilst maximizing crew safety and minimizing the impact of medical events on the mission.
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Curr Opin Anaesthesiol · Dec 2016
ReviewAssessing the value of risk indices of postoperative nausea and vomiting in ambulatory surgical patients.
Postoperative and postdischarge nausea and vomiting have profound impact on the efficient delivery of quality healthcare. In addition to patient dissatisfaction, physical morbidities as well as unplanned hospital admissions may result. It is important to risk stratify and intervene on patients at risk. The aim of this review is to explore the benefits and shortcomings of the scoring systems commonly used today. ⋯ Risk-stratifying scoring systems seek to identify patients at risk for postoperative/postdischarge nausea and vomiting. A protocol-based approach is recommended. A number of risk stratification systems have been validated and have been simplified for widespread adoption. Some institutions report a decrease in postoperative nausea and vomiting rates when an algorithm is followed based on one of the three scoring systems. By identifying at risk patients, an anesthetic can be better planned. A reduction in the incidence of postoperative/postdischarge nausea and vomiting will have a direct effect upon patient satisfaction, morbidity, and healthcare costs.
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Curr Opin Anaesthesiol · Dec 2016
ReviewAn update on pain management for elderly patients undergoing ambulatory surgery.
The aim of this review is to provide an overview of the drugs and techniques used for multimodal postoperative pain management in the older population undergoing surgery in the ambulatory setting. ⋯ The nonopioid analgesic therapies will likely assume an increasingly important role in facilitating the recovery process and improving the satisfaction for elderly ambulatory surgery patients. Strategies to avoid the use of opioids and minimize opioid-related side-effects is an important advance as we expand on the use of ambulatory surgery for the aging population.