Current opinion in anaesthesiology
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Palliative sedation, the conscious induction of sleep in patients with a very short life expectancy who suffer intractable physical and existential distress, may offer the patient and his or her relatives a more peaceful dying. This technique is still subject to several ethical and medical controversies justifying a review of the recent literature on this subject. ⋯ Palliative sedation may be considered for terminally ill patients who suffer intractable symptoms. Ideally it should be included in the patient's trajectory that has been described and discussed earlier when the disease was judged to be incurable. The main goal is to offer comfort.
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To review the current anaesthetic management of patients undergoing transthoracic oesophagectomy. ⋯ Although nonsurgical treatments are being developed, at present surgery remains the mainstay of potentially curative treatment. Accurate risk stratification would greatly facilitate the assessment of strategies to reduce operative mortality. Anaesthetic research has the potential to further improve the safety of patients undergoing oesophageal surgery.
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Curr Opin Anaesthesiol · Feb 2007
ReviewAnesthesia for thoracic surgery in morbidly obese patients.
This review considers the anesthetic management of obese patients undergoing thoracic surgery. Extremely or morbidly obese patients differ from patients of normal weight in several ways. Obese patients have altered anatomy and physiology, and usually have associated comorbid medical conditions that may complicate their operative course and increase their risks for postoperative complications. ⋯ With proper attention to their special needs, the morbidly obese patient can safely undergo thoracic surgery and one-lung ventilation.