Current opinion in anaesthesiology
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The control of pain after scoliosis surgery is a real challenge for the anesthesiologist. The first reason is that major spine surgery for correction of scoliosis deformation causes severe postoperative pain, and second that patients undergoing these operations are most often children or adolescents who are known to suffer from increased pain sensation compared with adults. ⋯ Significant improvements have been made in the control of postoperative pain after correction of scoliosis deformation in recent years. The introduction of epidural analgesia has cleared the way for better analgesic techniques in this surgical context. Properly performed and assessed, the addition of epidural analgesia after scoliosis surgery is a safe and effective form of analgesia and the benefits far outweigh the risks.
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Curr Opin Anaesthesiol · Jun 2008
ReviewNeuromuscular and mitochondrial disorders: what is relevant to the anaesthesiologist?
The review provides an up-to-date information to the anaesthesiologist about the more frequent and important neuromuscular disorders for which new basic insights or clinical implications have been reported. ⋯ The increased understanding of the genetics and pathophysiology of common muscle disorders may lead to a decrease in life-threatening complications related to surgery and anaesthesia. However, there is still a lack of prospective clinical studies to determine which is the safest anaesthetic technique for these patients.
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Curr Opin Anaesthesiol · Jun 2008
ReviewPostoperative complications in elderly patients and their significance for long-term prognosis.
To outline perioperative risk factors for postoperative mortality in older patients, the relationship of these factors with long-term mortality, and to examine possible strategies to reduce mortality. ⋯ Strategies are needed to prevent, or at least adequately manage, complications in elderly patients. Agreed international definitions for risks and complications can help in assessing risks and benefits.
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The present study summarizes the knowledge to date of the use of remifentanil in obstetric anaesthesia and analgesia. ⋯ Remifentanil has a place in obstetric anaesthesia and analgesia. Further studies are needed to confirm if background infusions are safe in addition to patient-controlled analgesia. Studies are needed to establish a dose range under general anaesthesia that prevents neonatal respiratory depression at birth.
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Curr Opin Anaesthesiol · Jun 2008
ReviewEpidemiology and morbidity of regional anaesthesia in children.
To evaluate which techniques of regional anaesthesia are made in 2008 and to appreciate and check their safety. ⋯ Regional anaesthesia is very much used in the child and develops very quickly. The peripheral accesses represent the majority of the regional techniques used. Continuous injection, after central or peripheral accesses, also progresses. There are complications in podiatry after regional anaesthesias. In most cases, they are not serious permanent problems, but they are probably underestimated. Modern approaches of treatment for the nervous structures (neurostimulators and echographs) are available and are used more often in order to increase the effectiveness. Careful use of the neurostimulator and ultrasonography may probably improve the safety in paediatric regional anaesthesia in the years to come.