Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Aug 2016
ReviewDo we really need sugammadex as an antagonist of muscle relaxants in anesthesia?
Sugammadex is a selective relaxant-binding agent that is designed to encapsulate rocuronium and chemically similar steroidal muscle relaxants such as vecuronium. This review summarizes recent information on the use of sugammadex in clinical practice. ⋯ Sugammadex offers a significantly faster and more predictable recovery profile than neostigmine. It is now possible to reverse rapidly and efficiently any level of neuromuscular blockade and to avoid the risk of adverse events because of residual paralysis such as critical respiratory events during recovery from anesthesia.
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Curr Opin Anaesthesiol · Aug 2016
ReviewThe challenges of implementing electronic health records for anesthesia use outside the operating room.
The nonoperating room environment presents a number of distinct challenges for anesthesiologists in the implementation of electronic health records (EHRs). These include documentation compliance, billing, and room design. ⋯ The needs of anesthesiology practice should be carefully incorporated into future EHR builds as demands for anesthesia care outside of the operating room expand.
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Curr Opin Anaesthesiol · Aug 2016
ReviewPractical considerations in the development of a nonoperating room anesthesia practice.
More than 25% of the procedures necessitating an anesthesia provider's involvement are performed outside the operating room. As a result, it is imperative that the expansion of anesthesia services to any new nonoperating room anesthesia (NORA) location takes into account the challenges and safety considerations associated with such a transformation. ⋯ Involvement of anesthesia providers at the development stage and an understanding of the administrative and clinical challenges are essential elements in the building of a NORA practice.
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Curr Opin Anaesthesiol · Aug 2016
ReviewPractical considerations in the management of sedation for colonoscopy.
The purpose of this review is to discuss the unique elements of providing anesthesia services for colonoscopy including the practical issues within an endoscopy suite, nothing by mouth status for colonoscopy, chronic medication instructions, appropriate anesthesia equipment, informed consent, pharmacology of agents for sedation, anesthetic techniques, and issues related to postprocedural care. ⋯ Sedation for colonoscopy is a rapidly expanding subspecialty with special needs created by the increasing medical complexity of the patients, the demands of the endoscopy procedures, the challenges of the endoscopy suite, and the rapid turnover of the outpatient environment.
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Curr Opin Anaesthesiol · Aug 2016
ReviewModel-based drug administration: current status of target-controlled infusion and closed-loop control.
Drug administration might be optimized by incorporating pharmacokinetic-dynamic (PK/PD) principles and control engineering theories. This review gives an update of the actual status of target-controlled infusion (TCI) and closed-loop computer-controlled drug administration and the ongoing research in the field. ⋯ Evidence in the literature is increasing that TCI and closed-loop technology could assist the anaesthetists to optimize drug administration during anaesthesia.