Current opinion in anaesthesiology
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Toxicity concerns and awareness during anesthesia issues continue to concern pediatric anesthesiologists. Most developmental pharmacokinetic, pharmacodynamic and pharmacogenomic changes occur within the first year of life. Understanding these early changes can improve drug use in this cohort. ⋯ Mechanistic models create a framework for the study of pharmacokinetic changes in infancy. Understanding these changes allows a target concentration approach to therapy and potential for reduced toxicity. The target concentration may be undefined because of a paucity of effect measures.
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Curr Opin Anaesthesiol · Jun 2009
ReviewComparison of different techniques of laryngeal mask placement in children.
The insertion of laryngeal mask airway is not always easy in children, and many techniques are described to improve success rate of placement. It is very important to determine the optimal insertion technique as unsuccessful prolonged insertion and multiple attempts are associated with adverse respiratory events and trauma in children. This article will review different techniques studied recently for the placement of classical laryngeal mask airway in children as well as recent findings of cuff pressure and depth of anesthesia for laryngeal mask airway placement. Laryngeal mask airway in children has undergone many modifications such as ProSeal laryngeal mask airway to improve its functioning. This article will also review different insertion techniques for ProSeal laryngeal mask airway. ⋯ Rotational technique may be considered as the first technique of choice for classical laryngeal mask airway insertion in children. The routine use of cuff pressure monitoring is mandatory during the use of laryngeal mask airway in children. Modification of laryngeal mask airway in children, that is ProSeal laryngeal mask airway, is promising and improves the success rate of insertion.
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Curr Opin Anaesthesiol · Jun 2009
ReviewPresent and emerging strategies for reducing anesthesia-related maternal morbidity and mortality.
As the demographic of pregnant women continues to change, anesthesiologists will need to continue to find new ways to prevent morbidity and mortality. In this article several new and emerging strategies to meet this challenge are discussed. ⋯ Over the past 50 years, the field of anesthesiology has reduced the rates of anesthesia-related maternal mortality and major morbidity considerably. As the obstetric demographic becomes older and more obese, new technologies and strategies can assist in keeping maternal death and major morbidity vanishingly rare.
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Curr Opin Anaesthesiol · Jun 2009
ReviewCommunication between anaesthesiologists and patients: how are we doing it now and how can we improve?
The purpose of this review is to present and bring together the relatively small body of recent work on anaesthesiologist-patient communication. ⋯ Communication between anaesthesiologists and patients is essential for effective clinical practice. Some practical suggestions are made and pointers to further reading given.