Current opinion in anaesthesiology
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In past years, cerebral monitoring was mostly focused around global cerebral perfusion and metabolism monitoring, with the use of transcranial Doppler recordings, jugular bulb oximetry and near-infrared spectroscopy. Most of the recently introduced cerebral monitoring modalities, such as brain tissue partial oxygen tension monitoring and cerebral microdialysis, offer new opportunities by providing regional information on the specific brain area in which the probe is inserted. ⋯ In this case, the combination of global and regional cerebral monitoring might offer the best information on which to base patient management. Also, the introduction of more clinically useful, functional neuroimaging techniques may be a valuable adjunct to future neurological critical care management.
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Tramadol is a unique analgesic offering moderate, dose-related pain relief through its action at multiple sites. In contrast to pure opioid agonists, it has a low risk of respiratory depression, tolerance and dependence. ⋯ It may have advantages in paediatric and day-case surgery and as an adjunct in local anaesthetic techniques. This review provides an evidence-based account of the role of tramadol in modern practice.
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Since the first report of alpha2-adrenoceptor agonists, the list of clinical indications for this class of drugs continues to expand. Alpha2-adrenoceptor agonists have several beneficial actions during the perioperative period. ⋯ Furthermore, alpha2-adrenoceptor agonists may offer benefits in the prophylaxis and treatment of perioperative myocardial ischaemia and their role in pain management and regional anaesthesia is increasing. The development of new, highly selective compounds which not only reduce anaesthetic requirements but induce anaesthesia by themselves may provide a new concept for the administration of anaesthesia.
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Curr Opin Anaesthesiol · Jun 2000
Perioperative considerations in the management of the patient taking herbal medicines.
The use of herbal products has recently increased dramatically in the United States. Patients are flocking to use these and many other complementary or alternative therapies. ⋯ The following review will discuss the limitations of Food and Drug Administration protection, and will review as well as provide an outline of the potential adverse reactions and side-effects that might affect anesthesia administration. To date, no double-blind, placebo-controlled studies have been carried out that specifically address herbal-anesthetic interactions or outcomes.