Current opinion in anaesthesiology
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Perioperative β-blocker use should be tailored for patient and surgical risk factors, most importantly because of the association with increased mortality and stroke when their use is generalised.
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Curr Opin Anaesthesiol · Jun 2020
ReviewPediatric burn resuscitation, management, and recovery for the pediatric anesthesiologist.
The purpose of this article is to summarize literature in pediatric burn resuscitation and management that is relevant to the pediatric anesthesiologist. The scope of the literature is expanding as long-term survival in even the most critically ill, burn-injured children has increased. ⋯ Literature review continues to reveal underpowered or retrospective analyses of these very important questions. Public health burden caused by burns warrants rigorous, prospective studies to take the best care of these patients and portend the best long-term outcomes. Collaboration amongst pediatric anesthesiologists who care for these children is necessary to develop and execute powered studies to answer important questions.
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Curr Opin Anaesthesiol · Jun 2020
ReviewPreeclampsia and the anaesthesiologist: current management.
Preeclampsia diagnostic technologies continue to advance. Peripartum care is improved with multidisciplinary teams, specialist anaesthesia care and the availability of critical care support.
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In the absence of abnormal placentation, perioperative management of repeat cesarean section is almost the same as for primary cesarean section.
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Curr Opin Anaesthesiol · Jun 2020
ReviewHypotension after spinal anesthesia for cesarean section: how to approach the iatrogenic sympathectomy.
Hypotension during cesarean section remains a frequent complication of spinal anesthesia and is associated with adverse maternal and fetal events. ⋯ Current evidence favors a combined approach of low-dose spinal anesthesia, adequate fluid therapy and vasopressor support to address maternal spinal-induced hypotension. As none of the available vasopressors is associated with relevantly impaired maternal and fetal outcomes, none of them should be abandoned from obstetric practice. Rapid crystalloid co-loading is of equivalent efficacy as compared with colloids and should be preferred because of a more favorable risk profile.