Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Aug 2020
ReviewSoft drugs in anesthesia: remifentanil as prototype to modern anesthetic drug development.
The unique demands of modern anesthesia practice require that medications be effective, well tolerated, and efficient. These attributes are increasingly achieved with the soft drug approach, wherein novel active compounds are specifically designed to be susceptible to rapid biotransformation to inactive metabolites. The present review summarizes the historical background and recent trends in soft drug development in anesthesiology. ⋯ With succinylcholine as the historical forerunner and remifentanil as the modern prototype, the soft drug paradigm continues to hold promise for the future of anesthesia drug development.
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To discuss the recent results of the use of interventional radiology modalities treating postpartum hemorrhage (PPH). ⋯ The use of aortic balloon occlusion catheters for the prevention of PPH and uterine artery embolization for the treatment of PPH are well tolerated and feasible options for patients with placenta accreta spectrum.
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Curr Opin Anaesthesiol · Aug 2020
ReviewIs there a place for regional anesthesia in nonoperating room anesthesia?
General anesthesia and monitored anesthesia care (MAC) are the most widely used techniques in nonoperating room anesthesia (NORA). However, regional anesthesia is slowly finding viable applications in this field. This review aims at providing an update on the current practice of regional anesthesia techniques outside of the operating theatre. ⋯ Regional anesthesia is finding its way into broader applications every day, offering a range of potential benefits in anesthetic care. Its implementation in NORA is promising and may aid in decreasing patient morbidity. However, great care should be taken in applying the recommended safety precautions for regional anesthesia in any setting.
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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
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