Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Aug 2015
ReviewSedative medications outside the operating room and the pharmacology of sedatives.
There is a growing medical demand for suitable sedatives and analgesics to support the ongoing progress in diagnostic procedures and imaging techniques. This review provides an update of the pharmacology of the most commonly used drugs used for these procedures and shortly mention new drugs on the horizon. ⋯ Clinicians should be aware of the pharmacokinetic/pharmacodynamic differences of all agents in order to select appropriate medications for specific procedures and patients.
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Curr Opin Anaesthesiol · Aug 2015
ReviewPreprocedural evaluation: considerations outside of the operating room.
There are an increasing number of procedures performed in locations outside of the operating room both for children and adults. From the perspective of the anesthesiologist, the preprocedural evaluation is essential in providing safe and high-quality care. This review focuses on the purpose, considerations and methods for providing information during the preprocedural evaluation process based on the most recent literature review. ⋯ It is important for the anesthesia provider to perform a thorough preprocedural evaluation. Tests that are ordered as part of the evaluation are done to understand the current medical state, verify a condition or formulate a plan. Informed consent must be obtained and the risks and benefits of the anesthesia plan in a manner understandable to the patient and parent or care giver.Many pediatric patients undergoing procedures outside of the operating room are in good health, and their evaluation will be relatively routine. Other children will present with complex medical conditions that require more time for the evaluation process. This may include the consultation of a pediatric specialist(s) as a necessary step toward completion of the preprocedural evaluation.Similarly, there are adult patients undergoing procedures outside of the operating room, which will have a straightforward preprocedural evaluation and others are more complex. Disease states that might require further testing include diabetes, leukemia, kidney and liver disease, central nervous system disease, malabsorption syndrome, coronary artery disease, coagulopathies and patients on diuretics.
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Curr Opin Anaesthesiol · Jun 2015
ReviewUpdate on perioperative care of the cardiac patient for noncardiac surgery.
The current review will address key topics and recommendations of the recent 2014 update of the American College of Cardiology and American Heart Association clinical practice guideline for the perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. ⋯ In conclusion, this review will discuss the important topics from the 2014 American College of Cardiology/American Heart Association guideline in order to provide the perioperative physician with the most recent evidence necessary to minimize major adverse cardiac events in patients undergoing noncardiac surgery.
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Curr Opin Anaesthesiol · Jun 2015
ReviewMaternal critical care: 'one small step for woman, one giant leap for womankind'.
The purpose of this study is to outline the challenges of looking after women who either become or are at a risk of becoming critically ill during pregnancy. ⋯ In this review, we identify the need for maternal critical care, explore different models of its provision and outline possible benefits and barriers to its future implementation.