Current opinion in anaesthesiology
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With recent research trying to explore the pathophysiologic mechanisms behind vasospasm, newer pharmacological and nonpharmacological treatments are being targeted at various pathways involved. This review is aimed at understanding the mechanisms and current and future therapies available to treat vasospasm. ⋯ Endovascular therapy has shown consistent benefit in relieving vasospasm. An aggressive combination therapy through various routes seems to be the most useful approach to reduce the complications of vasospasm.
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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.