Current opinion in anaesthesiology
-
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.
pearl -
Curr Opin Anaesthesiol · Jun 2020
ReviewPrehabilitation: the anesthesiologist's role and what is the evidence?
Surgery poses major threats to functional independence. Prehabilitation is a preoperative conditioning intervention that aims to prevent or attenuate surgery-related functional decline and its consequences. The present review is to summarize most recent evidence on the effectiveness of prehabilitation on key topics in cancer care, such as perioperative functional capacity, surgical and oncologic outcomes. ⋯ Prehabilitation prevents functional decline associated with major cancer surgery. Evidence is still needed to support its effectiveness in relation to postoperative complication, length of hospital stay, tumor progression, response to medical treatment, and survival. Ongoing and future research is essential to prompt the role of perioperative medicine in cancer care.
-
Curr Opin Anaesthesiol · Jun 2020
ReviewPerioperative anaphylaxis: diagnostic challenges and management.
Perioperative hypersensitivity reactions can pose diagnostic and management challenges for the anaesthetist. Difficulties in diagnosing hypersensitivity reactions in the perioperative setting are highlighted and recommendations from recent guidelines on the acute management of life-threatening anaphylaxis are presented. ⋯ Perioperative hypersensitivity reactions are rare but can be life-threatening. A high index of suspicion should be maintained for their successful management. Whenever a perioperative hypersensitivity reaction is suspected, close collaboration between anaesthetist and the allergy team investigating the patient is paramount, in order for the patient to be appropriately investigated and have an uneventful anaesthetic in the future.
-
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.
pearl -
Curr Opin Anaesthesiol · Jun 2020
ReviewCombined spinal epidural for labour analgesia and caesarean section: indications and recommendations.
The combined spinal-epidural offers faster-onset and superior labour analgesia.
pearl