Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Aug 2012
ReviewAnesthetic management of children undergoing hematologic-oncologic procedures outside the operating room.
There is an increasing demand on anesthetic services to provide care for children undergoing hematologic-oncologic procedures outside the operation room; in particular, to mitigate the pain and unpleasant side-effects of these treatments. This review provides an update of the latest findings on this topic. ⋯ Treatment of children undergoing hematologic-oncologic procedures outside the operation room is challenging. Expertise and high standards are essential to assure patient safety.
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Cardiac arrhythmias are a major source of morbidity and mortality. Many of these patients require diagnostic or therapeutic intervention in an electrophysiology laboratory with involvement of an anesthesiologist. The goal of this review is to provide the anesthesiologist with a comprehensive understanding of the mechanisms underlying various arrhythmias; specific procedures performed for diagnosis and treatment, and associated risks. ⋯ By reviewing the current literature regarding electrophysiology procedures, this review will provide information essential to the anesthesiologist to safely care for this unique patient population.
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Curr Opin Anaesthesiol · Aug 2012
ReviewPediatric dermatologic procedures performed outside the operating room.
Pediatric dermatologic procedures performed outside of the operating room are often painful and frequently require general anesthesia. Laser procedures constitute a relatively small but significant group of the growing number of these encounters. This article reviews relevant dermatological pathophysiology, current treatment modalities and collates currently available evidence to inform the best practice in anesthetic care of these patients. ⋯ Anesthesiologists are increasingly providing care for children undergoing dermatologic out-of-operating room procedures. Similar general considerations for out-of-operating room anesthesia equally apply to children undergoing these procedures. There are few recently reported data pertaining to this patient population and further work is needed.
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Curr Opin Anaesthesiol · Aug 2012
ReviewComputational genetic discoveries that could improve perioperative medicine.
The review examines the rationale and translational utility of computational genetic studies using murine models of biomedical traits. ⋯ The results have generated new treatments for alleviating incisional pain and narcotic drug withdrawal symptoms, which are now in clinical trials. A recent study identified allelic differences affecting chronic pain responses in mice and humans, which may enable a new 'personalized' approach to treating chronic pain.
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Curr Opin Anaesthesiol · Aug 2012
ReviewFundamental concepts of epigenetics for consideration in anesthesiology.
Epigenetics dictate how the genetic blueprint is ultimately expressed and, therefore, is fundamental to our understanding of disease etiology and cellular responses and consequences to exposure of stimuli, such as anesthetics and perioperative stress. The goal of this review is to provide a concise overview of the fundamental concepts in epigenetics and discuss how epigenetics may be incorporated into research studies in anesthesiology. ⋯ Epigenetic mechanisms underlie many human pathological conditions and impact clinical management in a variety of contexts. Although epigenetic research related to anesthesiology is sparse at the present, the full understanding of the mechanism of action of analgesics, interindividual variations in responses to anesthetics and consequences of exposure to anesthetic drugs will likely require the evaluation and integration of epigenetic information into current research paradigms.