Journal of perioperative practice
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The decision to transfuse patients perioperatively is made on an individual basis and should consider factors such as duration and severity of anaemia, symptoms, physiological parameters and comorbidities. Autologous blood transfusion has the benefit of avoiding some of the immunological and infective complications associated with allogenic blood transfusion. Pharmacological agents as well as anaesthetic and surgical techniques have a role in avoiding the need for blood transfusion.
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The authors have combined experience of over forty years working within the NHS and private hospitals as registered operating department practitioners. It is widely accepted that obesity is a growing problem in the populations of all developed and, increasingly, developing countries. ⋯ Furthermore, where there is the presentation of a clearly high risk patient, there can be limitations in optimizing the environment for reasons such as saving time, a lack of resources or sheer apathy. This article reviews the challenges, assessment and solutions available to the clinician faced with a high BMI patient with particular reference to the technique of ramping.
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If you should ask me to name the most important date in the whole history of surgery, I would reply, without a moment's hesitation, Friday October 16th 1846. The operation was a simple, almost trivial procedure, the removal of a small benign lump in the neck, but it marked the watershed between the past agonies of surgery and the modern era, where our patients enjoy the blissful oblivion of anaesthesia.
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Regional anaesthesia has become more popular in recent years with an emphasis on cost effectiveness, bed occupancy, and reduction in hospital acquired infections (HAls). Anaesthesia is a worrying time for any patient, but now the emphasis is to encourage patient empowerment by involving patients in their own care throughout their holistic journey. This article explores patient selection for regional anaesthesia, and the different types of central and peripheral blocks in line with national policies. The equipment required, pharmacology, toxicity of local anaesthetics, and their physiological effects on the cardiovascular, respiratory, and gastrointestinal systems of the body will also be discussed.