Best practice & research. Clinical anaesthesiology
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Best Pract Res Clin Anaesthesiol · Mar 2005
ReviewPerioperative management of the chronic pain patient.
The chronic pain patient has certain distinctive features important for her/his perioperative management. Altered opioid sensitivity and behavior are the major points to be considered. ⋯ Although a number of characteristics-including increased opioid demand, underreporting of pain, and non-compliance--are known, only a few specific recommendations are available, viz. adequate increase of opioid dose for analgesia, continuation of pre-operative opioids and coanalgesics to prevent withdrawal, and intensive education to strengthen the patient's coping potential. No differences between specific techniques for post-operative analgesia (e.g. systemic, patient-controlled or regional analgesia) have been shown so far.
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Best Pract Res Clin Anaesthesiol · Mar 2005
ReviewThe pediatric patient and upper respiratory infections.
Children frequently present for elective surgery in the setting of an active or recent upper respiratory infection. Respiratory adverse events are increased in this setting, but the threshold for cancelling a case varies widely between clinicians. ⋯ More data are needed on the risks of proceeding with surgery in the presence of these factors and on the impact of potential therapies to decrease the incidence of adverse events. Lidocaine and other therapies that reduce laryngospasm in well patients need to be evaluated in children with upper respiratory infection.
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Best Pract Res Clin Anaesthesiol · Mar 2005
ReviewIs there an evidence-based approach to anesthesia education?
Education in anesthesiology offers a variety of unique forums. Examples include focused teaching in the operating room, bedside teaching in critical care settings, and simulations. Many approaches are used by educators with a wide range of effectiveness. ⋯ Developing effective teachers maintains quality in training, promotes interest and enthusiasm for academia, and provides role models for learners. Evidence-based approaches to education are increasing in anesthesiology. This chapter will discuss skills, techniques, and evaluative tools from the literature that illustrate evidence-based effectiveness and applications to anesthesiology.