Current opinion in anaesthesiology
-
Curr Opin Anaesthesiol · Aug 2013
ReviewInterventional radiology in the pregnant patient for obstetric and nonobstetric indications: organizational, anesthetic, and procedural issues.
As indications for interventional radiology procedures during pregnancy continue to expand, anesthesiologists must be aware of the indications for specific procedures as well as provide the safest possible anesthetic care to both the mother and the fetus in nontraditional environments. ⋯ The risk to the fetus of the imaging procedure must be weighed against the benefit to the mother of early and accurate diagnosis and treatment of the underlying pathology. As the organizational aspects of providing care become more complex, simulation, guidelines, and protocols may become important to the safe care of these patients.
-
Curr Opin Anaesthesiol · Aug 2013
ReviewStandard approaches for upper extremity nerve blocks with an emphasis on outpatient surgery.
Currently, no standards exist with regard to the techniques and administration of ultrasound-guided peripheral nerve blocks. Consequently, the techniques and teaching substantially vary among practitioners and institutions. The purpose of this review is to propose a set of standard US-guided techniques for upper extremity nerve blocks. ⋯ A set of structured recommendations and approaches are suggested to help standardize clinical practice and teaching of ultrasound-guided upper extremity nerve blocks. Additional emphasis is placed on the discussion of nerve blocks in outpatient surgery.
-
Curr Opin Anaesthesiol · Aug 2013
ReviewManagement of the anticipated and unanticipated difficult airway in anesthesia outside the operating room.
The number of diagnostic and interventional procedures outside the operating room has dramatically increased over the last years. However, providing well tolerated anesthesia with the same standard of care in these locations is often challenging to the anesthesiologist. The remote locations include different organizational aspects and hazards. Airway management in general is still confronted with scenarios of difficult intubation and ventilation and often leads to significant morbidity and mortality. Continuous awareness of the potential complications is urged when providing anesthesia for remote procedures. ⋯ Airway management outside the operating room is challenging and needs the implementation of algorithms including the new airway devices. The recent update of the practice guidelines about difficult airway management of the American Society of Anesthesiologists remains the standard reference guide.
-
Curr Opin Anaesthesiol · Aug 2013
ReviewAnaesthesia or sedation for paediatric MRI: advantages and disadvantages.
The purpose of the present review is to place the current literature into historical context of what is understood about the conceptual as well as practical differences between sedation and anaesthesia, and what the potential benefits and risks may be, where paediatric imaging is concerned. ⋯ One single method cannot be applied to all children. Many can be sedated, but others will need anaesthesia with careful airway management, and the accompanying skilled personnel. Service models should be developed and tested to ensure maximum efficiency of service delivery.