Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Aug 2021
ReviewSelective periarticular blocks for postoperative pain after hip and knee arthroplasty.
This review aims to provide an overview of selective periarticular blocks for postoperative pain after hip and knee arthroplasty and the current evidence for their use. ⋯ The pericapsular blocks of the hip (pericapsular nerve group block, iliopsoas plane block, hip block), genicular nerves block, and infiltration between the popliteal artery and the capsule of the knee play an increasingly important role in providing postoperative analgesia after hip and knee arthroplasty without impeding fast-track protocols.
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Curr Opin Anaesthesiol · Aug 2021
ReviewNational trends in nonoperating room anesthesia: procedures, facilities, and patient characteristics.
Nonoperating room anesthesia (NORA) continues to increase in popularity and scope. This article reviews current and new trends in NORA, trends in anesthesia management in nonoperating room settings, and the evolving debates surrounding these trends. ⋯ NORA is a rapidly growing field of anesthesia. Continuing discussions of complication rates and mortality in different subspecialty areas will determine the need for anesthesia care and quality improvement efforts in each setting. As new noninvasive procedures are developed, new data will continue to shape debates surrounding anesthesia care outside of the operating room.
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Curr Opin Anaesthesiol · Aug 2021
ReviewAn update on pediatric sedation techniques in nonoperating room locations.
To review advancements in care for pediatric patients in nonoperating room settings. ⋯ Pediatric NORA requires thorough preparation, flexibility, and vigilance to provide safe anesthesia care to children in remote locations. Emerging techniques to reduce anesthetic exposure, improve monitoring, and alternative staffing models are expanding the boundaries of pediatric NORA to provide a safer, more satisfying experience for diagnostic and interventional procedures.
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Curr Opin Anaesthesiol · Aug 2021
ReviewUpdates and controversies in anesthesia for advanced interventional pulmonology procedures.
Advanced bronchoscopic procedures continues to grow, and are now commonly used to diagnose and/or treat a variety of pulmonary conditions that required formal thoracic surgery in past decades. Pharmacologic developments have provided new therapeutic options, as have technical advances in both anesthesia and interventional pulmonology. This review discusses technical and clinical issues and advances in providing anesthesia for advanced bronchoscopic procedures. It also discusses some controversial issues that have yet to be fully resolved. ⋯ The anesthetic framework and the discussions presented here should help forge effective communication between the interventional pulmonologist and the anesthesiologist In the Bronchoscopy Suite nonoperating room anesthesia with the goal of enhancing patient safety.
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Curr Opin Anaesthesiol · Aug 2021
ReviewAnaesthesia for minimally invasive cardiac procedures in the catheterization lab.
The share of cardiac procedures performed in settings involving nonoperating room anaesthesia (NORA) continues to grow rapidly, and the number of publications related to anaesthetic techniques in cardiac catheterization laboratories is substantial. We aim to summarize the most recent evidence about outcomes related to type of anaesthetic in minimally invasive cardiac procedures. ⋯ Inappropriate sedation and concurrent inadequate oxygenation are main risk factors for claims involving NORA care. Current evidence deriving from TAVR shows that monitored anaesthesia care (MAC) is associated with shorter length of stay and lower mortality.